Community Hospitals

Manuela Perteghella Excerpts

Tuesday 16th June 2026 Westminster Hall

[Dr Roz Savage (South Cotswolds) (LD)]

I beg to move,

That this House has considered community hospitals.

It is a pleasure to serve under your chairship, Sir Jeremy, and I am grateful to have secured this debate. I want to begin by thanking Jo Posnette and Dr Helen Tucker from the Community Hospitals Association, who have been an enormous help in preparing for the debate. I welcome Jo, who is in the Gallery.

Last year, according to the Royal College of Emergency Medicine, around 15,860 patients died in NHS A&E departments in England while waiting for care that could have saved them. That is roughly 1,300 people every month—nearly 10 times the figure recorded in 2015. Every week, more than 300 people died a preventable death simply because they waited too long. Those numbers are shocking, but behind every number there is a real-life tragedy. Let us remember that human aspect throughout the debate.

I am sure I do not need to point out to colleagues that in rural areas the situation is often even more challenging. The ambulance takes longer to reach people, the journey to A&E is longer and, when services at a community hospital have been reduced to a limited number, as is currently happening in my constituency, there might be no early safety net to catch the patient before a crisis becomes a catastrophe.

[Manuela Perteghella (Stratford-on-Avon) (LD)]

I thank my hon. Friend for her passionate speech about community hospitals. In my constituency we have a fantastic community hospital with a minor injuries unit, but the unit is open only on Tuesdays, Wednesdays and Thursdays, with reduced hours. It could treat thousands more patients each year. Does my hon. Friend agree that opening minor injuries units for extended hours would help to relieve pressure on A&E departments in acute hospitals?

[Dr Savage]

My hon. Friend makes a good point. Not everybody can time their minor injuries to fall conveniently within the unit’s opening hours, so I absolutely sympathise with the challenge facing her local hospital.

--- Later in debate ---

[Dr Savage]

I absolutely agree with the hon. Lady’s point. I have been pressing the NHS to find out the criteria by which they will judge the trial closure, but the criteria have not been forthcoming. I am concerned that there is a circular logic: “Well, you’ve managed without that ward for six months or a year, so you can continue to manage without it.”

A constituent described a cardiac arrest at Cirencester, handled with what she called “absolute skill and excellence” by a team of senior staff working together to stabilise the patient before transfer to an acute hospital. She told me that the nursing care on the wards is excellent, and that patients nearing the end of their lives are cared for with compassion and great dignity. That is what we are talking about when we talk about community hospitals, and that is what the trial closure of a ward potentially puts at risk.

Another constituent—a former GP who started practicing in Cirencester 40 years ago, in 1986—told me about a child who, after the surgical ward closed, waited 20 hours in Cheltenham for an appendix operation. Previously, that operation could have been done in Cirencester much more quickly. That is a family sitting in a corridor in an unfamiliar hospital at 2 in the morning, feeling anxious and far from home, because the local service they relied on had gone.

A month or so ago I launched a petition, in collaboration with a local county councillor, to protect community hospitals across the Cotswolds. Within a couple of weeks, well over 3,000 people had signed it, and last week we handed it in at No. 10. The South Cotswolds population is growing rapidly, largely due to the Government’s housing targets. Thousands of new houses are being built around Cirencester, and there are plans for many more housing developments that will swallow up nearby villages. It does not make mathematical sense for communities to grow while the services that support them shrink. The numbers just do not add up.

NHS bodies often describe these changes as reconfigurations—a shift in how care is delivered rather than a reduction in what is available. For a rural resident with no car and negligible public transport, a 25-mile journey to Cheltenham is a significant barrier to care. The Government’s own 10-year plan talks about “neighbourhood health” and care “closer to home”, but Gloucestershire is heading in the direct opposite direction. I would like to hear from the Minister how those two things can be reconciled.

A few miles to the north-west of my constituency, post-natal beds at Stroud maternity hospital were suspended in 2022. That year, the Care Quality Commission rated Gloucestershire’s maternity services as inadequate—a rating they retained on reinspection the following year. The hon. Member for Stroud (Dr Opher), who is a GP, has made the valid point that post-natal care saves money downstream because it is the time when mothers and babies bond, when breastfeeding is established and when families who need extra support get it on a timely basis. If we lose that support, the costs will appear elsewhere later on. Will the Minister provide a timeline, with dates, for the full restoration of maternity services in Gloucestershire, including the Aveta ward in Cheltenham, which is currently closed for labour and births? Will she provide details of the specific workforce support the Government are providing to make that happen?

In other countries, the decline of community hospitals is not seen as inevitable. Other countries are under the same pressures, but they are making different choices. In Sweden, research found that rural GPs value community hospitals because they provide exactly the things that cannot be replicated in a large acute centre, including proximity, continuity and a holistic understanding of elderly patients and others with multiple conditions. Heart failure and pneumonia rehabilitation can be managed closer to home by staff who know the patient and their family.

In Italy, the Government have committed to building or renovating 400 community hospitals using European recovery funds, backed by research from the Emilia-Romagna region showing that they deliver better integration among care sectors, between primary and specialist staff, and between healthcare and the communities it serves. Last October, more than 150 people from 23 countries joined an international webinar co-hosted by the Community Hospitals Association, and the conclusion was consistent: community hospitals anchor care in local communities, support home-based care and help people to live better for longer.

The Government’s NHS 10-year plan commits to shifting care from hospital to community. That sounds like a very good idea, but a Nuffield Trust report published in September 2025 makes a point that needs to be heard: this ambition is not new. Successive Governments have promised to move care closer to home, and most have fallen short, almost always because the community infrastructure needed to enable the shift is simply not there, and nor is the investment. Ireland, which has pursued reform for nearly a decade, had the wisdom to invest up front in new facilities, digital systems and community workforce capacity.

Unfortunately, the Nuffield Trust found that England’s 10-year plan contains no equivalent ringfenced funding. The expectation appears to be that hospitals cut waiting lists and simultaneously release funds to build community capacity. Again, the maths just does not work.

The starting point is already challenging. More than 1.1 million people are currently waiting for community care in England, with the steepest rise among children and young people. A hospital where the theatre has been paused cannot absorb more community care. A maternity unit closed for three years cannot deliver neighbourhood health. A community health system with 1.1 million people already waiting cannot become the landing ground for patients displaced from acute settings unless it is properly resourced to do so. As so often, rural areas pay the highest price when the gap between ambition and delivery opens up. There is no slack in the system and no easily accessible option down the road.

[Manuela Perteghella]

My hon. Friend is very generous to give way again. In my Stratford-on-Avon constituency, the Ellen Badger community hospital in Shipston-on-Stour served the community for hundreds of years. The Coventry and Warwickshire integrated care board removed the in-patient beds, which were really important in rehabilitating and looking after patients from acute settings before they went home. Those beds were close to their home. Does my hon. Friend agree that the Government must invest in care in community hospitals to relieve the pressure on acute settings?

[Dr Savage]

I absolutely agree with my hon. Friend’s point. We need a more joined-up approach. From conversations that I have had with nurses in my constituency, I know that those on the pointy end can see very clearly where the bottlenecks in the system are. We need to relieve the pressure on those bottlenecks.

I will conclude with five asks for the Minister. First, will the Government give a clear commitment to protect and properly resource Cirencester hospital as a local health hub, with the operating theatre restored, not paused indefinitely while the trial closure quietly becomes permanent?

Secondly, will the Government give a timeline, with dates, for the full restoration of maternity services in Gloucestershire, including post-natal provision at Stroud?

Thirdly, will the Government give an honest account of how the shift from hospital to community will actually be delivered in rural areas? What oversight will there be? What protections are in place? What prevents the same pattern of managed reduction from continuing in the name of the 10-year plan?

Fourthly, will the Government commit to work with the Community Hospitals Association towards a national definition and dataset for community hospitals in England, so that our 500 community hospitals can finally be planned for, funded and properly valued?

Finally, will the Minister agree to a meeting? I would very much welcome the opportunity to sit down with her, alongside local NHS leaders and the Community Hospitals Association, to discuss the long-term future of Cirencester hospital, its role and resourcing, and its place in the vision of care closer to home, which this Government say they believe in.

My constituents are not asking for anything exceptional. They just want to know that, if they get ill, there is somewhere to go that they can get to. The NHS was founded on that promise, and that promise must be kept.

Community Pharmacies

Manuela Perteghella Excerpts

Tuesday 2nd June 2026 Westminster Hall

[Rachel Gilmour]

I agree wholeheartedly.

I want to turn to two issues that I consider to be the systemic failures underlying all others: workforce and integration. On workforce, the community pharmacy network lost 3,000 full-time equivalent pharmacists between 2021 and 2025. That is not a sustainable trajectory. There is a specific incoherence in current policy that I must name. If one arm of the national health service is funded to recruit pharmacists away from community pharmacy while community pharmacies are simultaneously expected to take pressure off the same system, that is not joined-up workforce planning; it is quite simply the left hand not knowing what the right hand is doing.

The introduction of independent prescribing is laudable and long overdue, and I note that it is expected to come later this year, but I ask for more specificity from the Minister. What is the Government’s current timetable for making independent prescribing a routine, commissioned part of NHS community pharmacy services? If we train pharmacists to prescribe and then fail to commission services that let them do so in community settings, we will have wasted a major opportunity, and we will have trained a cohort of professionals whose skills are systematically underused.

On integration, Pharmacy First will not reach its full potential if GPs, hospitals, NHS 111 and patients all have a different understanding of how it functions. The incongruence within the system is hobbling pharmacy practice. What is required is proper system-wide integration, with pharmacies recognised as a fundamental pillar of our NHS. As the NHS modernisation Bill progresses through Parliament, that must be recognised. 

Pharmacies are already doing the work that the Government say they want the NHS to do. They are the first port of call, the most accessible point of contact and the trusted face of healthcare on high streets and in rural communities across this country. The Government have taken some positive steps, and I reiterate that the 10.3% uplift is very important. The direction of travel towards community care, independent prescribing and neighbourhood health is right, but direction without sufficient resource is just aspiration.

[Manuela Perteghella (Stratford-on-Avon) (LD)]

Although I also welcome the funding uplift, community pharmacies were already in crisis after years of real-term funding cuts, especially in rural areas. Does my hon. Friend agree that the Government need to scrap unfair budgetary pressures on community pharmacies and commit to a funding model that will put them on a sustainable financial footing for years to come?

[Rachel Gilmour]

Of course, I fully agree with my hon. Friend’s comments, and I laud her good work in her constituency. I urge the Government to commit to above-inflation funding increases year on year in order to close the £2 billion gap identified by their own independent analysis, deliver proper integration across the NHS and address the workforce crisis before it becomes irreversible. Pharmacies are ready, they are willing and they are already delivering. The question is whether the Government will match that commitment with the funding and the strategy that the sector and our constituents deserve. I look forward to hearing hon. Members’ contributions.

Dementia Care

Manuela Perteghella Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Manuela Perteghella (Stratford-on-Avon) (LD)]

I thank my hon. Friend the Member for South Devon (Caroline Voaden) for bringing this important debate to this Chamber.

Dementia is one of the most urgent public health crises we face, and one that profoundly affects so many of my constituents; according to Alzheimer’s Research UK, 1,800 people are living with dementia in our area. The current package of care for those living with dementia is simply not good enough. Far too many of my constituents speak of delayed diagnoses, exhausted kinship carers and gaps in social care provision.

Last year, I joined the brilliant Warwickshire Reminiscence Action Project in Stratford-upon-Avon to hear directly from people in my community living with dementia and their carers. Their stories were heartbreaking and moving, much like those we have heard in the Chamber today. There are many dementia cafés and social groups around my constituency, which provide information, much-needed support, and memory and sensory activities. We must support care workers, including by equipping them with specialist training, and kinship carers, who give everything, often with little recognition or support. Improving the availability of respite care is one step forward.

I have to say that I was deeply disappointed that the Government have dropped their target of diagnosing two thirds of those living with dementia. Early and timely diagnosis is absolutely crucial for individuals and their families. As my hon. Friend the Member for South Devon said, we need a proper workforce plan for social care, and to ensure that every person living with dementia receives timely, high-quality care, while making sure their carers are properly supported, too. That can be achieved only with early diagnosis.

We also know that dementia is an intersectional issue, with those from disadvantaged backgrounds disproportionately affected. Falling diagnosis targets and longer delays for appropriate care will fall hardest on those who cannot afford to go private. Dementia is also a rural issue; in communities such as mine, the risk of isolation for dementia patients is even greater, as is the need for strong local support. Families impacted by dementia often have to wait far too long to get the best support.

Make no mistake: this is not just about compassion. Dementia already costs the UK economy £42 billion a year, a figure that is projected to more than double by 2040 if we do not act.

In conclusion, I ask that we do not row back on care commitments, and that we have a dementia care plan that eases pressure on our acute settings while giving patients and their families the support they need when they need it.

Oral Answers to Questions

Manuela Perteghella Excerpts

Tuesday 6th May 2025 Commons Chamber

[Wes Streeting]

I take the Select Committee seriously, and I will look carefully at its report, but the shadow Minister has some brass neck. He mentions this Government having been in office for 10 months, but the Conservatives had more than 10 years in office, and we are picking up the pieces from the mess they left behind. That is why they were kicked out of government, and why they are being kicked out of opposition. Looking at this lot, I think: this must be how the islanders felt, looking at the dodo.

[Manuela Perteghella (Stratford-on-Avon) (LD)]

7. What recent assessment he has made of the adequacy of access to emergency dentistry.

[The Minister for Care (Stephen Kinnock)]

We are already rolling out our manifesto commitment of 700,000 extra urgent dental appointments per year. These appointments are available across the country for those experiencing painful dental issues such as infections, abscesses or cracked or broken teeth. We are committed to reforming the dental contract and making NHS dentistry fit for the future.

[Manuela Perteghella]

The dental contract imposed in 2006 is widely recognised as a key factor driving dentists out of the NHS. In my constituency of Stratford-on-Avon, there are no NHS dentists currently taking on new patients, and existing NHS patients are being actively pressured to go private or seek care out of county. Will the Minister commit to urgent reform of NHS dentistry, and set out a timeline for negotiations, so that I can reassure my constituents?

Hospitals

Manuela Perteghella Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Stephen Kinnock]

My hon. Friend is making some very strong points on behalf of his constituents. We would certainly be very happy to work more with him on some of those innovations. So often, hospitals are anchor institutions—alongside universities—for driving forward innovation, harnessing the power of technology and contributing to the Government’s growth mission. There are huge opportunities there, and I would be happy to explore them further with my hon. Friend.

[Manuela Perteghella (Stratford-on-Avon) (LD)]

Despite overwhelming support, the Coventry and Warwickshire integrated care board has decided to cut all beds at the Ellen Badger hospital in Shipston-on-Stour, an anchor building and community hospital that is at the heart of our town. Does the Minister agree that cutting such vital services is unacceptable, and that community hospitals play an important role in rural areas by providing equality of access to our health services?

[Stephen Kinnock]

The hon. Lady is absolutely right that community hospitals play a vital role, and I share her disappointment with the decisions that are being made. The fact of the matter is that we are in a hole, and we have to dig ourselves out of that hole. It is going to take some time to do that. We are getting the public finances back on an even keel, we are getting our public services back to where they need to be, and we are getting the economy back on a sounder footing. As we make those achievements, I hope that we will be able to reverse some of the decisions that are being made—decisions that are, of course, damaging to the hon. Lady’s community—but we are in a very difficult position, and it will take some time for us to get over that.

Oral Answers to Questions

Manuela Perteghella Excerpts

Tuesday 25th March 2025 Commons Chamber

[Manuela Perteghella (Stratford-on-Avon) (LD)]

My constituents are being forced to travel out of county to Coventry or Evesham to obtain basic NHS dental care. Does the Minister agree that it is a disgrace that access to an NHS dentist has become a postcode lottery? What urgent steps are the Government taking to end this dental desert and restore NHS services to rural communities such as mine?

[Stephen Kinnock]

I absolutely agree. The state of NHS dentistry in our country is shameful. The golden hello scheme enables 240 dentists to receive a £20,000 joining bonus payment to work in dental deserts, and we are negotiating with the British Dental Association the long-term reform of the contract. The issue is not the number of dentists in the country, but the paucity of dentists who are doing NHS work.

Obesity: Food and Diet

Manuela Perteghella Excerpts

Monday 20th January 2025 Commons Chamber

[Manuela Perteghella (Stratford-on-Avon) (LD)]

I thank the hon. Member for Stroud (Dr Opher) for securing this important debate, and I thank all the Members who have contributed so passionately. When we talk about obesity, and in particular childhood obesity, we must not overlook the structural barriers that prevent healthy choices. Several key policies could make a transformative difference, and I will draw attention to some of those tonight, but I will start by saying that every family in the UK in the 21st century should have access to affordable, healthy and nutritious food. The covid-19 pandemic contributed to an increase in household food insecurity and food poverty, widening health inequalities. Recent increases in food costs have become one of the primary contributors to the cost of living crisis. Tackling food insecurity in our communities is a step towards reducing obesity. It requires a restructuring of the whole system that takes into consideration how we produce, source, sell and prepare our food.

Early years nutrition is critical. Financial support schemes need to be expanded and increased in value. The current rates are inadequate, leaving many families unable to provide their children with a nutritious start in life. Expanding free school meals would be a game changer. The lack of a healthy, nutritious diet does not just affect physical health; it affects a child’s ability to learn and thrive. Universal access to free school meals would ensure that every child had at least one nutritious meal a day, reducing health inequalities and supporting educational attainment.

Last year, Stratford-on-Avon district council, on which I am a councillor, passed unanimously my motion to tackle food insecurity in our area. It included looking at how planning policy can help reduce unhealthy diets by, for example, encouraging community food growing, the creation of food co-operatives and limiting the spread of fast-food outlets.

I pay tribute to the Warwickshire food forum partnership, which developed a Warwickshire-wide food strategy along the priorities of access and affordability, food education and sustainable choices. I welcome the “Right to Food” campaign supported by many councils in England that are working towards making access to food a legal right, embedding food justice in their policies and calling on the Government to have the right to food enshrined in law.

Finally, we need to look at how we disincentivise unhealthy food choices that are high in calories and low in nutrients. The soft drinks industry levy has been effective, but we must close some of its loopholes by extending it to high-sugar foods and milk-based drinks. That revenue could be reinvested in public health initiatives, creating a positive cycle of preventing disease. Such measures and policies are not just about tackling obesity but about creating a healthier and fairer society. I urge the Government to make the changes that our communities so desperately need.

Winter Preparedness

Manuela Perteghella Excerpts

Wednesday 18th December 2024 Commons Chamber

[Karin Smyth]

I commend my hon. Friend for, as a new MP, getting to grips in detail with what is happening in her local system and challenging that system, while also giving us those examples of good practice so that we can all learn from them. As she says, many parts of the NHS across the country want to learn from them, and we want to ensure that they are mainstreamed where possible. There are different solutions for different systems, but she is absolutely right to highlight that one.

[Manuela Perteghella (Stratford-on-Avon) (LD)]

I refer the House to my entry in the Register of Members’ Financial Interests as a member of the University College London Hospitals NHS Foundation Trust.

The upcoming rise in national insurance contributions could cost our GP surgeries the equivalent of more than 2 million appointments a year. General practice is the cornerstone of the NHS; it is our front door. Many GPs in my constituency have written to me to express their serious concerns. Does the Minister recognise that hiking costs for family doctors will only worsen pressures on our hospitals, pushing more people towards A&E and preventing many from receiving the care they need?

[Karin Smyth]

We recognise all the costs to GPs, as contractors, and to many other parts of the system, as we have said many times in the House. We also recognise the improvements that we have made to the system by improving the number of GPs and funding the NHS by more than the last Government did. We will continue to look at that in the round to ensure that we have a sustainable system.

Access to Primary Healthcare

Manuela Perteghella Excerpts

Wednesday 16th October 2024 Commons Chamber

[Manuela Perteghella (Stratford-on-Avon) (LD)]

Access to NHS dentistry is deeply affecting my constituents in Stratford-on-Avon, with many communities facing what can only be described as dental deserts. We have seen dentists leaving NHS services in recent years, leaving residents with limited options. In some cases, my constituents are waiting months for an appointment, are forced to travel significant distances to see an NHS dentist or, worse, are told that they must pay privately or go without. Some have resorted to emergency care, and others have even attempted DIY interventions.

The lack of access to NHS dental appointments can have serious long-term health implications. Dentists can detect conditions such as oral cancer, diabetes and osteoporosis during routine appointments. We have heard that across the country, 4.4 million children have not seen an NHS dentist in the past year, which is shameful.

The situation is worsening in my area, with more NHS dentists opting out of the system because the current dental contract is unsustainable. It is not a surprise that patients are being removed from NHS lists, exacerbating the crisis. Recent research by Healthwatch, based on a series of national polls, shows that disabled people and those with long-term health conditions are more likely to avoid going to the dentist because of the cost.

The Liberal Democrats’ dental rescue package proposes investing in additional dental appointments, reforming the broken NHS dental contract and ensuring that everyone in need of urgent or emergency care can access an NHS dentist in their locality. We should give our constituents the right to register with their local NHS dentist. I therefore urge the Government to act now before the crisis deepens even further.