Public Access to Nature

Debate between Rachael Maskell and Margaret Greenwood

Thursday 18th May 2023 Commons Chamber

[Rachael Maskell]

I thank the hon. Gentleman for that point and could not agree more. It often comes down to funding in schools and being able to afford those opportunities for young people to experience the natural environment. That should not be the case, because we know how that further bakes in inequality. Of course, at a time when children really need to access nature, they are denied it. We have such incredible assets all around us, so we need to provide that opportunity to young people.

[Margaret Greenwood (Wirral West) (Lab)]

My hon. Friend is making an excellent speech. Will she join me in congratulating Second West Kirby Sea Scouts on the work they do to take children out on the water and give them the experience of enjoying water sports? I met them recently at a May Day fair, where they said they were sure that they would have about 15 children sign up to go kayaking and so forth, but they were looking for volunteers. Does she agree that the work of volunteers is invaluable in that regard?

[Rachael Maskell]

I am grateful to my hon. Friend. As a former Beaver Scout leader and someone who is much involved in the scouting movement, I know the value that scouting and guiding bring to many of my constituents. Of course, we need scout and guide leaders—that is always the issue. Volunteers gain so many skills as well, so I urge people to come forward and enjoy that too.

We often talk about these things in this place, but if we do not see that opportunity hardwired into legislation and Government strategy, it often becomes talk and not action. For example, I spent six months on the Bill Committee for the Levelling-up and Regeneration Bill, bringing forward amendments that aimed to provide greater access to nature, whether by developing one of the missions to focus on nature or by bringing forward opportunity for access to nature and protection of nature, which is vital at this time.

In that Bill Committee I made arguments about how we use our brownfield sites. I would like the Minister to respond on this. In debates in this place, we often hear that we must drive development on brownfield sites. However, I have witnessed in York how a brownfield former rubbish dump has been turned into St Nicks nature reserve, providing real access to nature in an urban environment. When we are developing brownfield sites, we need to think about opportunities to create wildernesses and parks. We even need to be thinking about exchange with green- belt land so that we do not push everything into the urban centres, denying access to nature to people living in urban environments while there is so much for everybody else. We could look at that policy to ensure that we get a fairer share. With that legislation, we talk about using little pockets of land for development, but those are often where people in those communities have the opportunity to enjoy nature. We should look at protecting those areas for community interest purposes.

I thank those who have campaigned long and hard to provide access, right back to the Kinder Scout movement and to this very day. In York, I see the work that York Cycle Campaign and Walk York are doing to open up access. It is not always just about getting there. That is a major issue, and for that I thank the dales and moors buses who take people out, including facilitating day walks for people from the urban environment, giving them an opportunity to experience the natural environment while ensuring that there are things to do.

That is where i-Travel York comes in. It has created interactive maps so that as people go on cycle routes and walks, they can know what places to go, what they are looking for and what kind of nature to spot. That is why we must ensure that we facilitate the travel. I welcome reducing the cost of buses that go out into the environment, but there is too little infrastructure. We need to address that. People also need to know what to do when they get out into the natural environment and how to enjoy and get the most out of it.

We recognise how during lockdown so many people were trapped in flats and urban environments. Getting that reconnection is really important. Social prescribers are doing fantastic work by opening up opportunities, but we must ensure that they are properly funded and that that programme can be built up even more. We know that when people access nature, their physical and mental health improves. We have heard how about £2.1 billion could be saved, but I agree with the hon. Member for Worcester (Mr Walker) that it could be far more. There is talk of £7.4 billion to the wider economy, and of course there is the difference that could make to people in our communities. The mortality gap in my constituency —just in York—is 10 years, so we know that inequality is clearly embedded in people’s ability to walk and enjoy the natural environment; that must be closed.

We need that programme of nature recovery to be integrated with human recovery. I think hard about what happened after the pandemic in many schools and getting that focus on children’s wellbeing. Some independent schools put farming and engagement in the natural world on their curriculum. However, in many state schools it was a case of young people having to work harder at the core subjects, which the Government identified, in order to catch up—as opposed to being able to catch up with themselves. In fact, that caused greater harm to those individuals rather than the replenishment that nature could bring.

We also need to look at where people can stay when they are out in the community. We have heard much about the opportunity to visit places, but I would argue that people should have the right to wild camp and stay in locations. There is nothing like waking up to the dawn chorus or seeing a spectacular sunset in a wild area and getting that connection with nature. The opportunity to wild camp is therefore really important. Of course, we must preserve that land and take care of it while there. In just a week’s time, I will be packing up my tent and walking the hills with my father, who is now well into his 80s. We are both really excited about spending time together, recharging and climbing those hills once again. It is such a privilege, and I want everyone to enjoy that.

I want to raise with the Minister the decline in youth hostels across the country. I am a life member of the Youth Hostels Association. Rural hostels have been in decline and disappearing, and it is really important that we deal with that so that all ages can engage. In fact, the Government could do so much more to ensure that people have those stopping points. Certainly, for those walking a national trail without the infrastructure there, trying to find somewhere to stay can be a nightmare. I think about the Pennine way—I think it is 276 miles—where several of the youth hostels on the route have now disappeared, which makes it a difficult journey. It is really worth looking at where people can stay, whether camping or indeed in a youth hostel, so that everyone can access nature and enjoy those rural retreats.

In this debate we have talked about such joy, such opportunity and the amazing landscapes we have. Before I close, I want to touch on one more issue: bringing nature into the urban space. In York I want to see a city farm. I have long talked about the therapeutic benefits that could bring. We know from research that when animals are brought into care homes, it has helped residents and older people re-engage, re-live memories and feel connected. I want young people to be able to learn the basics of animal welfare, and for people with mental health challenges, and indeed all of us, to enjoy the opportunities and enrichment that a city farm can bring. We need those facilities in our urban environments to draw out the interest of young people to help them find themselves and to connect.

We need to see so much more ambition. We have a Labour Government coming, and I am excited about that because we can create wonderful connection and restore our rhythm of life.

NHS Staffing Levels

Debate between Rachael Maskell and Margaret Greenwood

Tuesday 22nd November 2022 Westminster Hall

[Margaret Greenwood]

The hon. Lady makes an incredibly important point. There can be no more poignant and devastating example of what this crisis is leading to.

The Health and Care Act is a privatising piece of legislation that opens the door to private companies having a greater say in the delivery of health care. Guidance by NHS England, while the Act was going through Parliament, stated that it would enable integrated care boards to delegate functions to providers, including devolving budgets to provider collaboratives. Provider collaboratives are partnership arrangements involving at least two trusts, and they can include representation from the private or independent sector.

As we now know, the delegation of commissioning from ICBs to provider collaboratives will definitely go ahead. That represents not only the opportunity for the privatisation of the NHS, but clearly has implications for NHS staff. I am concerned that a situation may well arise where a provider collaborative decides to commission services from the private sector, instead of from the NHS provider that is currently delivering the service. In that instance, NHS staff may well find that their jobs are lost from the NHS, and that equivalent work is available only in the private sector, on poorer pay and conditions of service.

The Health and Care Act, which was passed by the Conservative Government earlier this year, has the potential to undermine national collective bargaining, and the pay and terms and conditions of NHS staff. It also undermines the concept of the NHS as a publicly owned organisation that has served us so well since 1948. The Act prohibits the chair of an ICB from approving or appointing someone as a member of any committee or sub-committee that exercises commissioning functions, if the chair considers that the appointment could reasonably be regarded as undermining the independence of the health service, because of the candidate’s involvement with the private healthcare sector or otherwise. However, that is clearly open to interpretation. It by no means rules out people with interests in private healthcare from sitting on those sub-committees.

If we are serious about providing governance that rules out the possibility of the private sector influencing the expenditure of public money, an organisation carrying out the functions of an ICB on its behalf should be a statutory NHS body. It is a great pity that the Government did not legislate for that, despite an amendment in my name calling for it, which had cross-party support.

Private companies can also have influence through integrated care partnerships, which are required to prepare a strategy setting out how the assessed needs of its area are to be met. ICBs must have regard to a strategy drawn up by an ICP, which I am concerned might be influenced by private companies. Of course, the responsibility of a private company is to make money for shareholders; it is not to support a publicly owned, publicly run national health service.

Other provisions in the Act also have serious implications for staff. The Act allows for a profession that is currently regulated to be removed from statutory regulation. That is deeply concerning. Once a profession is deregulated, we can expect the level of expertise in that field to decline over time, alongside the status and pay of those carrying out those important roles. Deregulation also brings with it serious long-term implications for the health and safety of patients.

The Act also provides for the revoking of the national tariff and its replacement with a new NHS payment scheme. Engagement on the NHS payment scheme is still under way, with a statutory consultation due to begin shortly. I have long been concerned that, given the requirement in the Act for NHS England to consult with each relevant provider before publishing the NHS payment scheme, including private providers, this may well be a mechanism through which the Government will give private health companies the opportunity to undercut the NHS. If that happens, I believe that one of the inevitable outcomes would be an erosion of the scope of “Agenda for Change”, as healthcare that should be provided by the NHS is increasingly delivered by the private sector.

In that event, NHS staff may then find themselves forced out of jobs that are currently on “Agenda for Change” rates of pay, pensions and other terms and conditions, with only private-sector jobs with potentially lesser pay and conditions available for them to apply for if they wish to continue working in the health service. Just like the provision around provider collaboratives, that would appear to hold risk for NHS staff and their pay and conditions. As such, I would be grateful if the Minister will guarantee that the pay rates of “Agenda for Change”, pensions, and other terms and conditions of all eligible current NHS staff will not be undermined as a result of the adoption of the NHS payment scheme. Can he also confirm that trade unions, staff representative bodies and all the royal colleges will be consulted before the NHS payment scheme is published, as Ministers in the other place assured us during the passage of the Act?

I understand that the Government are to publish a comprehensive NHS workforce plan next year, including independently verified workforce forecasts of the number of doctors, nurses and other professionals we will need in five, 10 and 15 years’ time. Such a plan is long overdue, so can the Minister provide some further details about when we will see it? Will that plan also include details of the numbers of staff we will need in the social care sector, where there is also a workforce crisis that is intricately linked to that in the NHS? Will the Minister set out what measures he is taking to address the staffing crisis this winter?

[Rachael Maskell (York Central) (Lab/Co-op)]

The reality is that today, we are training NHS professionals in the same professional silos as we did 100 years ago. Medicine has moved on massively, so in light of the fact that a new workforce plan is being drawn up, is it not right that those professions are revisited to ensure we have a workforce fit for the future, as opposed to doing things just because we have done them for so many years?

[Margaret Greenwood]

As ever, my hon. Friend makes an interesting and detailed point born of her experience. The Minister should take note.

To conclude, since 2010, Conservative Governments have let the crisis in NHS staffing develop. Instead of doing the important business of Government and bringing forward a timely workforce plan and a properly funded training regime, they have focused their energy on not one, but two, major reorganisations of the national health service designed to open it up to privatisation. Instead of tending to the needs of the workforce and the needs of patients, they have been priming the pump for shareholders. The NHS must remain a comprehensive universal service, publicly owned, paid for through direct taxation and free at the point of use for all who need it. That very concept is under threat: it has been reported this week that NHS leaders in Scotland have discussed abandoning the founding principles of the NHS by having the wealthy pay for treatment, thus creating a two-tier system. Not only would that be a betrayal of its founding principles, but it would also bring in costly administrative processes that are not currently needed, as patients would need to be means-tested.

The NHS is also under threat from this Conservative Government’s failure to get a grip on the staffing crisis, and from their privatisation agenda. This attack on the fundamental principles of a comprehensive, universal, publicly owned national health service, free to all who need it and paid for through direct taxation, has left patients neglected and staff overworked and underpaid. Patients, the NHS, and all who work in the service deserve better. The Government must come forward as a matter of urgency with a credible plan to put things right for NHS staff and set out how they are going to deal with the crisis this winter, and Ministers must give NHS workers a fair pay rise, protect NHS services, and ensure staff safety.

GP Appointment Availability

Debate between Rachael Maskell and Margaret Greenwood

Tuesday 26th October 2021 Westminster Hall

[Rachael Maskell]

My hon. Friend hits the nail on the head. We cannot look at part of the health service without looking at the entire health service, and the pressures that are brought to bear. As we have heard, many people do go to their A&E or urgent care centre, because that is the only way that they know they can confidently access the service, which puts more pressure on those parts of the service. We must look at the whole.

However, when it comes to trying to engage with our community practitioners—that is what primary care is all about: people who would traditionally have known the patient and the family—medicine has changed so much, yet we have not caught up with where it is. I saw both the call handlers and the GPs facing burnout. They are reducing the number of sessions that they are working because, we must remember, a session then extends right through into the night, as they are catching up with paperwork, ordering tests and following things through. Individuals are just saying “If I don’t step back, it will have a serious impact on my own wellbeing.” We have got to protect the wellbeing of GPs. They are a precious resource in delivering our healthcare services.

[Margaret Greenwood]

My hon. Friend is making an excellent speech. Does she share my concern about the shortage of GPs? The Government have committed to having an extra 6,000 GPs by 2024 or 2025, I think. The pressures GPs are under is a direct consequence of the failure to address the issue.

[Rachael Maskell]

My hon. Friend raises the next point in my speech. We are in this mess because for over a decade we have had failed workforce planning across the system. We have seen that most acutely in primary care. The pandemic continues to be mismanaged, which I want to stress. The Government may be looking at the numbers when it comes to intensive care and hospital admissions, but as people are less sick they instead go to see their primary care physician. That puts more pressure on them. We need to see more measurements and data on the pressure that has been put on primary care during the pandemic. In addition, we have long covid as well. In York there are around 3,000 cases. It is not coded, so can the Minister get that sorted urgently? We need to look at the support that people with long covid require.