Rural Healthcare

Debate between Luke Evans and Anne Marie Morris

Wednesday 12th October 2022 Westminster Hall

[Anne Marie Morris]

That is an exceptionally fine point. I have no issue with it because we have a similar problem in Devon. The solution is not just about more recruitment and doing things in the same way, because the people to be recruited do not exist. We need to look at doing things differently, by creating new career paths with shorter training periods and trying to train, so we can then recruit, locally. Generally, people will follow a career where they are trained. We need more rural training for doctors and nurses, and that training needs to be not in the local city, but in the rural areas. For example, in Plymouth we have a fine medical school— Peninsula Medical School—but the challenge is that the experience that the individual trainee doctors and nurses gain is not rural, and it needs to be.

[Dr Luke Evans (Bosworth) (Con)]

My hon. Friend is making a fine point. From my experience, there is an opportunity: young doctors who are becoming GPs tend to be between the ages of 27 and 35. At that time, most people are looking to set up their family, go to school and get married. If we extend some of the career opportunities by extending training in those areas, they are more likely to bed down roots and gain a skill to become a GPSI—a GP with a special interest—in those areas. Does she believe that is a formula that the Government should look at?

[Anne Marie Morris]

I absolutely agree, and it is an excellent suggestion. In a similar vein, when we are asking primary care networks and others to deal with the backlog, it is important that we try to give them much more freedom in how they address the problem. I talk to many of my local commissioners, and they say that they are having to make decisions that they know are right, even though they are not currently in the guidebook as best practice. We need to give them that trust to be able to do the right thing.

C is for care. Members will not be surprised to hear that the adult social care discharge fund, although welcome, is not going to be enough. The reality is that the bed count is often low in rural areas. In the south-west, we have the lowest bed count per head of population; I think it is the lowest in western Europe, although I am happy for the Minister to correct me. It seems to me that we used to be moving towards saying, just in time, “Let’s have care in the community.” However, because of the shortage of care in the community, and the lack of proper validation that it works other than whether people are readmitted, we need to put a halt to closing community hospitals and to look at how they can be used. Some could be repurposed. Perfection can often be the enemy of the good.

Teignmouth Community Hospital in my constituency is on the closure list, but to me that is not a wise decision. There are no nursing care homes in the area. Without that residential care, and without adequate care in the community, removing the only other source of beds is not the way to solve the backlog problem.

Health Inequalities

Debate between Luke Evans and Anne Marie Morris

Wednesday 4th March 2020 Commons Chamber

[Dr Luke Evans (Bosworth) (Con)]

Does my hon. Friend agree that patient behaviour around rurality is different from those in the city? They have to make a decision when they are on their own whether to trouble the GP, to go out, to face the weather, to go to the hospital. When they really need to go, they leave it to the last minute. That creates an inequality that is not captured in the data.

[Anne Marie Morris]

My hon. Friend is totally right. There are some very big consequentials relating to the geography of our area and to the demographic profile. We tend to export young people and import older people. In consequence, we need more geriatricians. We do not need a lot of specialists; we need doctors who can cope with complex co-morbidities. We do not have doctors like that.

We need also more funding for primary care. Much of the funding is skewed towards accident and emergency. Why? Because that is where the measures are. We also need to look at how we overcome the infrastructure barriers. Road and rail, bad; 5G, great. But we do not have it. We ought to be a priority because that would be a real plus in trying to solve this rural problem.

We also need to train and recruit people who understand rural communities. If we do not train them in rural areas, they will not want to come and stay. Nurses working in hospitals and in social care need to be trained in a similar way and they need to be interchangeable, otherwise we cannot cope with the demand in social care. On mental health, as I think has already been mentioned, isolation and loneliness in rural areas mean that we have a very high level—I think the highest level—of suicide. We have lots of lone workers and lone livers. That is a real challenge.

The consequence of all that is that in Devon we find ourselves with some of the worst financial performance results and some of the worst results in terms of meeting targets. Why? Because we are being funded for the wrong thing in the wrong way. Nobody seems to notice that many in our community do not ever get ambulances. You try north Devon and parts of Cornwall—it is just not going to happen. The effect is that we are now in special measures. What does that do? Do we get help? Actually we get told to spend less. If that is not health inequality, I do not know what is. I hope the Minister will not tell me that people in rural areas live longer. It is not great to live longer if you are not in great health and the quality of your health really does not cut it.

This situation can change and it has to change. The Government need to accept that one size does not fit all. If the Government are willing to listen and to change, it can all happen.

I invite the Minister to come and listen to the evidence I am gathering while chairing a national inquiry into rural health and care. We are unpicking the issues. We are looking at evidence not only from across the United Kingdom, but from abroad—from New Zealand, Australia and America—of what good care looks like. We hope to provide the Minister with a toolkit for a good result. Thank you for listening.