Community Pharmacies

Rachel Gilmour Excerpts

Tuesday 2nd June 2026 Westminster Hall

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I beg to move,

That this House has considered the future of community pharmacies.

It is always a pleasure to see the Minister in his place. I know how committed he is to his brief, and I am grateful for the conversations we have had on a number of important issues. The timing of this debate could hardly be better, coming as it does in the wake of the Government’s announcement just before the weekend. That announcement provides the perfect context within which to couch my remarks. I would like to believe that I have developed a reputation for constructive criticism, and I hope to offer a fair-minded but frank scrutiny of the Government’s plans for community pharmacies. There are positive moves, which I welcome, but there is also considerably further to go.

It is clear that the national picture for community pharmacies is one of an incredibly fragile system, and I am sure that much reference will be made this morning to the damning headline statistic that since 2016, over 1,000 pharmacies have been lost across England. Funding was cut that same year and remained flat in cash terms until 2024, even as the volume of NHS pharmaceutical care and the cost of providing it surged.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

I congratulate the hon. Member on securing the debate. When I met the Minister in April, we were going through the consultation on the pharmacy contract, but we are yet to hear any announcement. Does the hon. Member agree that the pharmacies we all rely on need certainty about when their contract negotiations and the associated funding will be completed?

[Rachel Gilmour]

The hon. Member makes a good point, which I shall return to in due course.

The community pharmacy network has had to absorb real-terms cuts of 30% in Government funding. For most community pharmacies, NHS funding accounts for 90% to 95% of their annual income. That is simply not a sustainable business model; it is a slow strangulation. The Government’s own independent economic analysis, published as recently as March this year, found the gap to be £2 billion a year. More recently still, the Government have admitted that pharmacies in England were funded £800 million less in real terms in 2025-26 than they were a decade ago. It is important to be clear that those are the Government’s own figures.

Against that backdrop, I welcome the funding settlement for 2026-27.

[Claire Hazelgrove (Filton and Bradley Stoke) (Lab)]

As a fellow south-west MP, will the hon. Lady welcome the fact that the Minister came to the Concord pharmacy in Little Stoke in my constituency just last week to make the welcome announcement about £340 million more to boost our vital community pharmacies? Does she agree that when the Minister winds up, it would be helpful for him to share how he finds these visits valuable in forming his work in the Department and showing him more about the support that pharmacies need?

[Rachel Gilmour]

As I said at the beginning, the Minister is a very hands-on Minister, and I am sure he finds every visit absolutely fascinating.

The community pharmacy budget will increase by 10.3% to £3.636 billion. The introduction of independent prescribing into some pharmacy services later this year is a positive step, as are the measures aimed at stabilising the volatile medicines supply system. In the spirit of constructive opposition, I will certainly give credit where credit is due, but we must be honest: the settlement is still far short of what pharmacies need to keep their doors open. Over 600 branches closed last year alone.

[Adam Dance (Yeovil) (LD)]

Pharmacists such as Max, who runs South Petherton pharmacy, are taking care of constituents from the other side of my constituency. Our pharmacies in rural areas are expected to do more and more with little extra help. Does my hon. Friend agree that alongside greater funding, we need to see the Government use the NHS workforce plan to properly expand the pharmacy workforce?

[Rachel Gilmour]

As a rural MP myself, I certainly have a grasp of what my hon. Friend addresses, and I shall come to that in a minute.

Analysis conducted by the Independent Pharmacies Association shows that an average pharmacy dispensing around 10,000 items a month will face a shortfall of approximately £56,000, even after the settlement. Without a commitment to continued above-inflation funding increases year on year, patients will face an acceleration of service reductions and closures. Those closures will fall hardest on communities such as mine and that of my hon. Friend, as I will explain.

My constituents have lived with these difficulties. At a cursory glance, there are 16 pharmacies across Tiverton and Minehead, serving a population of approximately 91,200. On average, they dispense 113,000 prescriptions every month because they are busy, essential, community institutions. Yet a survey of 3,000 people in Tiverton, conducted by a local GP surgery, found that 30% of respondents were unable to find a pharmacy. That should simply not be the case in 21st-century Britain. It cuts to the heart of a fundamental truth about rural healthcare and much more that successive Governments have neglected to confront.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

I recently visited Weldricks pharmacy in Rossington and saw the amazing work done by the team there. My constituency is in quite a rural area and provision is patchy. Does the hon. Member agree that it would be good to map all community pharmacies, understand where there are gaps, and make targeted interventions? That would ensure provision for the number of people living in that area.

[Rachel Gilmour]

I agree that a strategic approach is always best. The distances, the limited public transport and the dispersed nature of rural populations mean that the closure of a single pharmacy can represent a genuine healthcare crisis for thousands of people. I see that directly in my constituency; the loss of a fully fledged pharmacy with all its associated services in Bishops Lydeard in March 2024 was a blow to the community. In its place there is now a dispensary, but solely for patients of the surgery. The same thing happened in Norton Fitzwarren. Transport woes, which so often hold back my constituents, sever a vital link to the health service.

Jhoots, the previous provider of pharmacy services in parts of Tiverton and Minehead, had operated poorly for some time. Constituents lamented the missing medicines, unexpected closures and queues stretching down the street. Under the new stewardship of Allied Pharmacies, things have improved markedly. That is a testament to what good management and proper investment can achieve.

[Edward Morello (West Dorset) (LD)]

My hon. Friend raises the spectre of Jhoots, which resulted in the closure of the Bridport and Lyme Regis pharmacies in my constituency. Jhoots exposed serious concerns around contractual failures, unsafe practices, staff treatment and service continuity, leaving staff in my constituency relying on food banks. When I met the Minister, he told me that officials were reviewing whether additional regulatory powers were required to prevent another Jhoots scandal. Does my hon. Friend agree that it is important for the Government to bring forward legislation to deal with such a scenario?

[Rachel Gilmour]

I have had that discussion with the Minister, who reassured me that the Jhoots scenario has been at the front of his mind and he will seek to resolve it.

There is also the question of business rates. It seems manifestly unfair that community pharmacies, which are frontline NHS providers in every meaningful sense, are required to pay full business rates, while GP surgeries and dental practices do not face the same burden. I ask the Minister how that disparity can be justified and whether the Government intend to address that.

Pharmacies are the engine of community care and offer an opportunity that the Government have not fully grasped. The thrust of the Government’s health strategy has been care in the community, devolving healthcare back to local settings, with neighbourhood health structures and a shift away from hospitals to primary and preventive care. All of that is absolutely right but cannot be delivered without the community pharmacy network. Pharmacies are already doing the work the Government say they want the NHS to do: local, preventive, accessible care, delivered by trusted professionals in the heart of communities. The funding must match the words.

[Amanda Hack (North West Leicestershire) (Lab)]

The hon. Member is making a powerful speech about the importance of community pharmacy. There are pharmacies on the edge of my constituency, serving Leicestershire, Nottinghamshire and Derbyshire. The inconsistency of integrated care board delivery can create problems for local communities trying to get medicines. Does the hon. Member agree that we need consistency of approach?

[Rachel Gilmour]

I assure the hon. Lady that some of the most frustrating conversations I have are with my local ICBs. Properly resourced pharmacies could release a staggering 51 million primary care appointments through an expanded Pharmacy First service, prevention services and a greater role in managing long-term conditions. That is 51 million appointments freed up in general practice, allowing more people to escape the infamous 8 am scramble. Pharmacies often meet people where they are, offering more accessible services to those who might not otherwise engage with the health service at all. They are arguably the most accessible arm of the NHS.

[James Naish (Rushcliffe) (Lab)]

I have been fortunate to have a pathfinder within the independent prescribing programme in my constituency. Its data shows that only 5% of patients who use the independent prescribing pathway need to be referred to their GP, so it is exactly as she says: there are huge savings to be made. I must push the Minister, because Community Pharmacy England has said that it is

“not persuaded that sufficient investment is being made to enable the full and effective introduction of independent prescribing.”

Does the hon. Lady agree that the Minister should look at that carefully to make sure that we are getting as much as we can out of community pharmacy?

[Rachel Gilmour]

I shall come to just that point in a minute. This sounds strange now, but I am going to say it: take obesity, for example. One in three people in the UK are currently classified as obese. Obesity is estimated to cost the NHS over £11.4 billion a year, with wider societal costs to the tune of £74 billion a year. Community pharmacies are ideally placed to provide wraparound support for those prescribed weight-loss medicines as part of an NHS-commissioned service, but they need the resources and the commissioning framework to do so.

There is one aspect of this debate that receives insufficient attention, and I want to raise it briefly. The ongoing situation in the middle east has hit the pharmaceutical supply chain as much as any other sector. There were a record 219 price concessions announced for community pharmacies in May alone, with further negotiations still ongoing. The cost of medicines has risen sharply. I understand that some cancer drugs have reportedly seen elevenfold increases. Crucially, medicine shortages and record-high price concessions reflect an instability in the supply chain that is being intensified by geopolitical pressures. I put it to the Government that the growing medicine supply crisis poses serious risks to Britain’s preparedness and resilience.

[Hannah Spencer (Gorton and Denton) (Green)]

I met with a pharmacy manager in Denton who told me that NHS reimbursement for medicines is not keeping pace with rising costs. They are dispensing medicines at a loss, paying more to suppliers than the NHS then reimburses them and absorbing the shortfall. Does the hon. Lady agree that independent pharmacies need to be fairly funded if they are to continue acting as the front door to the NHS?

--- Later in debate ---

[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.

--- Later in debate ---

[Rachel Gilmour]

I do not have time to go through the list of hon. Friends and hon. Members who have made fantastic contributions. Suffice it to say that there is only one negative aspect of this debate: the fact that not a single Conservative Member of Parliament is here is shocking.

I just want to say happy birthday to the hon. Member for Dunstable and Leighton Buzzard (Alex Mayer). I do not suppose she imagined that she would start her birthday by debating community pharmacies, but I hope she has a wonderful day.

Question put and agreed to.

Resolved,

That this House has considered the future of community pharmacies.

Ehlers-Danlos Syndrome and Craniocervical Instability

Rachel Gilmour Excerpts

Thursday 26th March 2026 Westminster Hall

[Rachel Gilmour (Tiverton and Minehead) (LD)]

It is a pleasure to serve under your chairmanship, Ms Furniss. I thank the hon. Member for Cannock Chase (Josh Newbury), who I would also be proud to call my hon. Friend, for bringing this debate to Westminster Hall. I do not think there is a single elected person sitting in this Chamber who does not realise what a wonderful privilege it is to represent all our constituents. But a day like today, when we have an opportunity to change the lives of people who suffer from EDS, is a particularly privileged day. I hold that thought at the front of my mind, and thank all Members for coming.

A few weeks ago I met one of the most brave, beautiful young women I have met in a long time. Her name is Stevie, and she lives in Willand, which is in the Devon part of my constituency. She came to see me, but she was quite worried about it because she had never been to see an MP before—there was a degree of trepidation. But she was so eloquent, passionate and determined to tell me about the impact that this dreadful disease had had on her life, I had no option but to come here today to repeat her words.

Like many of the constituents who have been mentioned, Stevie had to raise her own funds to get diagnosed and have the treatment. She was housebound and bedbound, and had to give up work. She has a wonderfully supportive husband who goes out to work six days a week to support her and their two young children, who happen to be autistic. What a beacon of honour and bravery—I just cannot imagine how she lives on a day-to-day basis.

Those with EDS have been left to suffer without the structures needed to make timely, evidence-informed decisions. Patients are not asking for predetermined outcomes or routine surgery; they are asking for recognition that suspected craniocervical instability in Ehlers-Danlos syndrome requires a defined process for assessment and management within the NHS.

Of Ehlers-Danlos Support UK members, 92% are not able to work because they are so affected by the condition. Almost half of those people were working, but had to give up entirely because of the syndrome’s debilitating impact. This is not just about people’s lives and their mental health; it is actually about supporting our country and enabling people with this syndrome who do want to work to make a contribution.

Rather than leaving patients to deteriorate to the point of having to consider neurosurgical options, there should be an early diagnosis. As many colleagues have said, establishing a specified EDS care pathway makes the case for itself. Earlier intervention would improve quality of life and strengthen the economic health of the country by enabling people with EDS to remain in work—like the member of staff of the hon. Member for Blaydon and Consett (Liz Twist).

It is true that the Department of Health and Social Care’s recognition of the complexity of EDS and the low awareness surrounding it is a step in the right direction. But I believe the central ask of this Government and the Minister is to heed the collective call from across the parties for a defined diagnostic and care pathway.

Disability Equipment Provision

Rachel Gilmour Excerpts

Wednesday 11th March 2026 Westminster Hall

[Seamus Logan]

I do agree. Indeed, that problem causes a massive cost to the taxpayer as well.

It is no surprise that 74% of equipment providers were aware of patients experiencing delayed hospital discharge due to unavailable community equipment. The APPG’s report recommended and called for the implementation of a national strategy to ensure the cohesive and comprehensive delivery, monitoring and financing of disability equipment.

Complaints about the current system and provision of equipment have been reported by various other organisations, including the UK charity for young wheelchair users, Whizz Kidz, which described wheelchair services as “underfunded, inaccessible, and fractured.” In June 2025, it was reported that Citizens Advice receives a new complaint about faulty aids every hour.

My own pedigree in this area goes back many years—in fact, to 1996, when I first joined a health and personal social services commissioning organisation, under the leadership of my great friends Mary Wilmont and Kevin Keenan, both former directors of social services in Northern Ireland. We examined in great detail the wheelchair services for people who were deaf or blind, hard of hearing or visually impaired. One report stands out in my memory—not because I authored it, but because it was a simple idea to address the challenges facing people in getting to a hospital appointment. We called it “Getting There”. That was 30 years ago.

Although this Government need to “get there”, the challenges in the existing system are more profound. In England and Wales, the provision of equipment is currently run by the NHS and local authorities, which are primarily responsible for facilitating care needs assessments and subsequently approving and providing equipment. As a result, available equipment, the length of waiting times and the quality of adaptations are increasingly becoming a postcode lottery.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

Does the hon. Gentleman agree that the patchwork system to which he referred is, through delay and dysfunction, denying many disabled people the independence they deserve? A 56-year-old constituent of mine in Somerset with a progressive muscle wasting condition has been left effectively housebound and in severe pain for months while trying to obtain essential wheelchair adaptations. May I appeal to the Minister’s extensive good will and ask him to look at that case?

[Seamus Logan]

I agree with the hon. Member, and that highlights the need for a national strategy and a review of the current organisational arrangements.

Age UK has noted that, due to a lack of national guidelines on timelines, long waiting lists are common, partly due to shortages in that noble profession, occupational therapists. To mitigate the situation, multiple organisations have been set up with the sole purpose of supporting those in need of disability equipment in the face of a failing system. They include Back Up, a UK-wide charity that works with people affected by spinal cord injury and provides vital wheelchair skills training. The Motability Foundation has awarded £36.4 million in grants to customers of its Motability scheme to help them access adequate and good-quality equipment, as many people have resorted to self-funding permanent or temporary equipment. The foundation has also conducted an economic assessment of wheelchair provision in England and recommended that greater integration across services is needed to prevent variation in the quality of provision.

In Scotland, the handling of disability equipment and adaptations is carried out by integrated authorities—united bodies in which local authorities and NHS services work together to provide more cohesive and community-focused health and social care planning. To guide those bodies, the Scottish Government agreed a memorandum of understanding some years ago, setting out a standardised approach for the provision of equipment to maintain consistency across all local councils. During engagement with voluntary organisations in this field, I was told that the Scottish approach is paying dividends. I recommend to the Minister that a similar approach should be considered for implementation in England and Wales, because the system needs change now.

Thousands of people across the UK are sick, sore and tired of being unheard after countless complaints. When will their voices be taken seriously? Greater national leadership is urgently needed to put an end to the insecure and uncertain system in which someone’s ability to obtain necessary life-supporting equipment is based on where they live rather than their need. Everyone has a right to access disability equipment and live a safe and independent life. The pressure is on the UK Government to step up and redesign the system, and respond to the many calls to establish a national strategy.

A consolidated approach holds the potential to improve oversight, reduce waiting times and ensure consistent and reliable access to disability equipment for everyone, no matter where they might live, so let me pose just one simple question to the Minister: in responding to the debate, will he please set out the reasons why he would not agree to take forward a national strategy in this area?

Healthcare in Rural Areas

Rachel Gilmour Excerpts

Wednesday 4th March 2026 Westminster Hall

[Rachel Gilmour (Tiverton and Minehead) (LD)]

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Mid Bedfordshire (Blake Stephenson), my colleague on the Public Accounts Committee, for securing this debate. Many hon. Members have today outlined problems in their constituencies that, I am afraid, are all too familiar in mine. I represent a disproportionately elderly population, which brings with it great wisdom as well as greater health challenges, particularly given that parts of my constituency are some of the least densely populated in England.

Shabby transport connectivity hobbles every aspect of my constituents’ lives. Perhaps no more acutely is this reality felt than in access—or the lack of access—to healthcare. For people in the West Somerset corner of my constituency, it can take two hours and two buses to reach Musgrove Park hospital in Taunton. I am told that a return fare would cost my constituents an eye-watering £180 in a taxi, which is simply unaffordable to most local people. These barriers delay diagnoses and treatment.

I am thankful to the Minister for Care for being a responsive member of his Government, but I cannot hide my disappointment at the decision to snub Minehead’s calls for a permanent CT scanner installation. The decision was supposedly reached because such a move was deemed uneconomical. It proved to be a game changer for so many local people, but it is indeed uneconomical because terrible transport links suppress demand.

To conclude, remoteness has not been given the weighting it should in the Government’s local government funding settlement. I implore the Government—and I hope the Minister takes this away—to undertake a real, forensic look at just how important rurality and remoteness is as a factor for the cost of healthcare delivery in rural areas.

Cross-border Healthcare

Rachel Gilmour Excerpts

Tuesday 4th November 2025 Westminster Hall

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

I beg to move,

That this House has considered cross-border healthcare.

It is an honour to serve under your chairmanship, Mr Dowd. Last year, hopes were raised that two Labour Governments working together would put an end to conflict between Cardiff Bay and Westminster, yet few issues trouble my constituents more than the daily reality of cross-border healthcare between England and Wales. Powys is a beautiful county, but it is also the largest in Wales, with no district general hospital of its own. Nearly 40% of the health board’s budget is spent commissioning services across the border in Herefordshire and Shropshire, because that is where the nearest hospitals are. When co-ordination between the Welsh and UK Government fails, it is Powys patients who feel it first and hardest.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

My hon. Friend is making a point about the border between England and Wales, but I represent a constituent who lives in a spot equidistant between two hospitals in Exeter and Taunton. Only one hospital could provide the treatment she needed, but the consultant there recommended rehabilitation at a third hospital across the border in Tiverton. After a lengthy back and forth, she was allowed treatment on the grounds of extenuating circumstances. Will my hon. Friend join me in pressing for a clear, binding system to allow seamless cross-border referrals where clinically appropriate?

[David Chadwick]

My hon. Friend makes a valid point, and I am sure her constituents will be pleased to hear her make it. The 2018 cross-border statement of values and principles promised that no patient would face delay or disadvantage because of which side of the border they live on, but my constituents know that those principles are not being applied in practice.

The clearest recent example of what has gone wrong is the new waiting list policy introduced by Powys teaching health board this summer. From 1 July, the board instructed English hospitals treating Powys residents to deliberately and artificially extend their waiting times, bringing them into line with the longer averages elsewhere in Wales. Until now, Powys patients had been treated in hospitals, such as Hereford and Shrewsbury, in exactly the same way as English patients, but from this summer they have been asked to wait up to twice as long.

We are told that hospitals in Herefordshire and Shropshire are treating Welsh patients “too quickly” and that Powys’s budget does not allow for the current number of people being treated each year, so patients have to be spread out over more years. How appalling it is to say that a patient can be treated “too quickly”. Swift treatment should be an objective, not a problem.

Worse still, this supposed cost-cutting exercise may not save a penny, because both the Wye Valley NHS trust and the Shrewsbury and Telford hospital trust believe that it could cost Powys more, because they will have to bill Powys teaching health board for the administrative cost of running two parallel waiting list systems. That is before we consider the hidden costs: the human and financial price of patients deteriorating while they wait longer, needing emergency admissions, extended rehabilitation and, in some cases, never recovering the quality of life they once had.

My constituents are not just numbers on a spreadsheet; their lives are on hold. Those months are months of agony, of lost work, of isolation, and of watching opportunities and life slip away while waiting for operations that should already have happened. Agnes is a patient from Llandrindod with Parkinson’s disease. She has been told that she must wait another 52 weeks for a knee replacement after already waiting a full year. That means a total of two years waiting for surgery. The delay has made it increasingly difficult for her to stay active, even though regular exercise is vital to managing Parkinson’s symptoms. The prolonged wait is worsening her mobility and pain, and it is undermining her ability to live independently.

Hazel, from Builth Wells, is awaiting spinal surgery in Hereford. Her expected waiting time has doubled to 104 weeks. She has been unable to work during this period due to numbness in her legs and feet, and she now fears losing her job. Once financially independent, she now relies on family support—an experience she describes as “degrading and unfair”—through no fault of her own.

Kelly was diagnosed with serious spinal disc problems in September 2024. She was given a surgery date for December, then March, but both were cancelled. Even though her pre-operative assessment had been completed, she later discovered—on her own—that her operation had been postponed by at least another year under the new policy. This is despite her being classed as an urgent P3 case and being told that existing bookings would not be affected. The delay has left Kelly in constant pain, which has taken a serious toll on her mental health and has contributed to her losing her job.

Those stories are not isolated; they speak for hundreds of others who are being quietly told to wait, not because of capacity or clinical need but because of budgetary decisions. Behind every statistic is a person whose life is being diminished while they wait for care that should already have been delivered.

What makes this even worse is that patients are sometimes not being told that their treatment has been delayed. Many have found out only through news reports or by doing their own investigations. Labour Governments at both ends of the M4 talk about driving down waiting lists and getting people back into work, yet this policy, which Ministers could stop tomorrow, does the exact opposite. The health board and senior Welsh Labour politicians call it “fairness” that Powys residents should wait no less than anyone else in Wales. However, fairness and ambition should mean lifting standards everywhere, not dragging Powys down to the lowest common denominator.

It is not equality; it is equal punishment for the Welsh Government’s failure to fix the NHS after 25 years in power. The response from Ministers thus far, particularly in Cardiff Bay, has been nothing short of disgraceful. The Health Minister, Jeremy Miles, could not appear more uninterested if he tried—no action, no intervention and no urgency from the one man who has the power to stop the policy and to get people out of pain and back to their lives. Several constituents have told me that they have written personally to him and have received no response at all. That is despite the fact that it is his Government who are forcing Powys teaching health board to make significant cuts to its budget.

As for the First Minister—who, I remind the House, represents Powys in the Senedd, as well as being a Member of the House of Lords—she brushed off my constituents’ concerns, saying that she thinks it is just “smoke and mirrors”. I invite her to say that directly to Kelly, Agnes and Hazel, because months or even years of their lives have been stolen and spent living in pain.

The decision institutionalises inequality between Wales and England. If the waiting list policy exposes a failure of funding, the digital infrastructure of cross-border healthcare exposes a long-term failure of systems. Despite 25 years of devolution, we still have national health services across our four nations that cannot share data efficiently. Both NHS England and NHS Wales still operate separate digital systems that do not talk to each other. When a Powys GP refers a patient to Hereford or Shrewsbury, information often travels by post, fax or unsecured email. Discharge summaries arrive late or not at all. Test results are duplicated because clinicians cannot see each other’s records, wasting time and often causing distress for patients.

Even in emergencies, A&E doctors in England cannot automatically view a Welsh GP’s records, and vice versa. To paint the picture more vividly, one Powys resident told me that he was admitted to Shrewsbury hospital with a serious heart condition, yet staff could not access his medical records. Because it was a Sunday, they could not even reach his GP by phone.

That should not be happening in 2025. It puts lives at risk across our border regions. The lack of interoperability affects anyone moving between the four nations of the United Kingdom, as their health records tend not to move with them. The Welsh Affairs Committee has been calling for change since 2015, yet a decade later, nothing has happened. The Welsh Government alone do not have the funding to overhaul their systems, which is why we have called on Westminster to step in, as obviously this is a consequence of devolution. For a fraction of the cost of other Government digital projects, modernising NHS IT across the UK would directly improve patient safety, continuity of care and confidence in the system. Every week that remains unresolved, more patients are put at risk, which is a failure of politics, not just technology.

GP Funding: South-west England

Rachel Gilmour Excerpts

Wednesday 25th June 2025 Westminster Hall

[Stephen Kinnock]

Integrated care boards in the south-west have received almost £1.3 billion in their primary medical care allocation for ’25-26, which is an increase of nearly 13% compared with ’24-25, so I am not quite sure where the hon. Lady is getting her figures. For me, a 13% increase is not a cut.

That growth in local resources includes the south-west’s share of the additional £889 million agreed for the GP contract, as well as the transfer of some additional roles reimbursement scheme funding that had previously been held centrally by NHS England. Those funding allocations will be further uplifted to fund in full the pay recommendations of the DDRB and the NHS Pay Review Body.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I appreciate that recruitment, including of GPs, is extraordinarily difficult in the south-west. In Minehead, there is one GP practice and just one doctor. He is outstanding, and everybody knows him—to that extent, he fits the named GP pledge—but he serves 11,000 people. Rural premium or not, would the Minister agree that that is simply unacceptable and unsustainable, irrespective of where in the country one might be?

[Stephen Kinnock]

That is an extraordinary statistic. There are clearly major imbalances in the way the system works and general practice is funded in our country. A little later I will come to the Carr-Hill formula; I am sure hon. Members will have seen announcements trailed in the media today about what my right hon. Friend the Health Secretary will say shortly in a speech in Blackpool. The issue raised by the hon. Member for Tiverton and Minehead (Rachel Gilmour) is directly pertinent to the work we are doing around the formula for funding GPs, to ensure that it is needs based, unlike the current, deeply anachronistic and dysfunctional funding system.

On funding, general practices are funded through a range of streams, the majority from core payments known as global sum payments. The rest is made up of incentive schemes, premises payments and enhanced and additional services. The Carr-Hill formula is applied as a weighting of 50% to 60% of GP funding allocated through the core contract, and is a workload-based formula designed to reimburse practices for their expected workloads.

The formula takes into consideration patient demographics, such as age and gender, and factors such as morbidity, mortality, patient turnover and geographical location. I am truly proud that today my right hon. Friend the Health Secretary is in Blackpool to announce that we are reviewing the Carr-Hill formula, which is outdated and not fit for purpose. Currently, GP surgeries that serve working-class areas receive on average 10% less funding per patient than practices in more affluent areas, and that needs to change.

Politics is about choices. For 14 years, the Conservatives —propped up for five years by the Liberal Democrats, I am afraid to say—chose to favour the richest. Who can forget the right hon. Member for Richmond and Northallerton (Rishi Sunak) boasting about how he had deliberately redirected funding from deprived urban areas to leafy suburbs? This Labour Government are reversing that ethos. Our decision to reform the Carr-Hill formula is a clear example of how we are putting our Labour values into practice.

We recognise the importance of ensuring funding for core services is distributed equitably between practices across the country. In our upcoming 10-year health plan, that is what we will do, through our review and reform of the Carr-Hill formula. Alongside that work, the Advisory Committee on Resource Allocation—ACRA—will be asked to advise on how the setting of ICB allocations can better support the reduction of health inequalities, to ensure that resources are targeted where they are most needed.

On workforce and recruitment, we recognise the difficult situation whereby patients have been unable to get GP appointments and recently qualified doctors have been unable to find jobs. That is why, in August last year, we announced £82 million in ringfenced funding, allowing primary care networks to recruit newly qualified GPs through the additional roles reimbursement scheme. More than 1,700 GPs have now been recruited through that scheme.

As part of the 2025-26 GP contract package, we made the additional roles reimbursement scheme more flexible, to allow PCNs to accommodate local workforce needs better. That includes removing restrictions on the number or type of staff covered, including GPs and practice nurses. When I took up my ministerial responsibilities in July, I was astonished to find that it was not possible to recruit GPs through the ARRS. We have bulldozed that red tape, which has resulted in a dramatic increase in the number of GPs on the frontline.

Department of Health and Social Care

Rachel Gilmour Excerpts

Tuesday 24th June 2025 Commons Chamber

[Rachel Gilmour (Tiverton and Minehead) (LD)]

There are very legitimate concerns about rumoured plans to merge integrated care boards across the country. When ICBs merge, the promise of unified oversight gives way to a bureaucratic structure that prioritises large-scale efficiency over the nuanced understanding of local communities. Each locality and its environs has its unique challenges, such as variable demographics, socioeconomic disparities and distinctive health issues that demand targeted solutions. A merged ICB risks offering one-size-fits-all strategies that overlook the finer details of local care. The resultant dilution in responsiveness not only alienates patients, but stifles innovative local approaches that have proved successful in addressing community-specific challenges. While attempts at driving efficiency are certainly laudable, we risk sacrificing the local approach for local needs.

In my constituency of Tiverton and Minehead, community hospitals in Williton, Minehead, Tiverton and Dene Barton in Cotford St Luke are anchor institutions providing essential care for my constituents. Communities in rural areas simply cannot afford to lose them. These facilities are often the only nearby source of medical attention, and that is critical when timely treatment can mean the difference between life and death.

Moreover, community hospitals offer the family and friends of patients the opportunity to visit and check on them without having to travel great distances to do so. As we know, this familiar contact is so often a crucial part of a patient’s journey to recovery. It is certainly true in Tiverton and Minehead that community hospitals help to reduce the health disparities found in rural settings compared with urban centres. Without them, residents in more remote areas would simply not have access to the same level of healthcare as those in more built-up areas. That is why, where possible, we must resist administrative reforms that ignore local distinctiveness, and at the same time invest robustly in the community pharmacy network and community hospitals.

NHS Funding: South-west

Rachel Gilmour Excerpts

Wednesday 11th June 2025 Westminster Hall

[Rachel Gilmour (Tiverton and Minehead) (LD)]

My constituency, which straddles the Devon-Somerset border, has a disproportionately elderly population. We have perhaps even greater and more regular healthcare needs than some other parts of the country, but significant funding shortfalls have hit GP practices particularly hard.

In the coastal west Somerset area, we have what are termed dental deserts. The percentage of adults in my constituency seen in the last two years by a dentist falls well under the national average. A&E departments see the effects of that down the line. The failure to treat ailments at an earlier stage often leads to conditions deteriorating and to serious complications, leaving A&E departments overwhelmed.

Let us not kid ourselves: the strains on A&E capacity are downstream from the insufficiency of GP and dental services, whose raison d’être is to provide routine and preventive care. We need a systemic overhaul to shore up GP and dental services so that they are fit to tackle the problems at their onset and remove some of the pressure on accident and emergency.

I am all too aware that healthcare professionals tend to practise where they trained, so we want to swell the ranks of our nurses, doctors and dentists in Tiverton and Minehead by providing locally based training colleges. In Tiverton and Minehead, we also have a shortage of pharmacies. Let us be clear: this is about essential medication. Finally, I have often talked about the lack of transport facilities in my constituency. The paucity of healthcare provision across my constituency coupled with the significant shortcomings in public transport creates a bleak picture indeed.

Attention Deficit Hyperactivity Disorder

Rachel Gilmour Excerpts

Tuesday 10th June 2025 Westminster Hall

[Freddie van Mierlo]

The hon. Gentleman is right to point out that increased awareness of a condition naturally leads to an increase in the number of people seeking diagnosis. I believe the same was true of left-handedness when that became less of a taboo.

I am told that seeing every person who is on a waiting list could cost as much as £3 billion to £4 billion. We must therefore find a way to target urgent, psychiatrist-led care where it is most needed, and to triage early so that the most severe cases get support, along with those who are already taking powerful medication. To that end, I welcome and commend the Government on the launch of the taskforce in March 2024. From the discussions that I have had, however, I know that the communication with ICBs has not been good enough.

The initial data from the taskforce shows that an estimated 2.5 million people in England have ADHD, with more than half a million on waiting lists. To end this farce, we need a system that is adapted to manage the new volume of patients with appropriate levels of care. It does not help to say that there is an overdiagnosis of mental health conditions, as the Health Secretary has said; rather, we need to look at models that will diagnose and treat all patients using the most appropriate tool for their level of need. A good start would be to include ADHD in the 18-week pledge on first appointments. Currently, ADHD treatment is not considered a consultant-led area, even though GPs cannot diagnose. Waiting times should be defined by ICBs, with NICE guidance.

The consequences of getting it wrong are clear. ADHD is a leading cause of school exclusions, lower academic achievement and increased drop-out rates, and 25% of the UK prison population has ADHD, with untreated symptoms often driving impulsivity and crime. Untreated ADHD is also strongly linked to substance misuse, family breakdowns and severe mental health issues.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I speak as the mother of man who was not diagnosed with ADHD until he was 31. Fortunately for him, he has a very good employer who has made his life considerably easier than it might otherwise have been. However, I am appalled to have found out recently that great institutions such as the British Army, the RAF, the Royal Navy and the police actively discriminate against people with ADHD and simply will not employ them. Does my hon. Friend agree that that is simply outrageous? Will he join me in calling on the Minister to change that?

--- Later in debate ---

[Karin Smyth]

I am not aware of the detail of the pathway in the hon. Member’s ICB. I suggest that that is a matter for him to discuss with the ICB, which will have heard his question about how it is delivering those services on the ground.

Members raised issues around shared care agreements and the difficulties that people with ADHD are experiencing in accessing medication through such agreements, particularly when they have received a diagnosis through a private provider. It is the responsibility of secondary care specialists such as consultants, rather than GPs, to initiate treatment of ADHD. However, sometimes a shared care agreement, in which the GP takes over monthly prescriptions and routine monitoring once the patient is happy with their medication and dosage, can be put in place. The General Medical Council, which regulates and sets standards for doctors in the UK, has issued guidance to help GPs decide whether to accept shared care responsibilities for any condition. NHS clinicians need to be content that any prescriptions or referrals for treatment for any condition are clinically appropriate. All shared care arrangements are voluntary, so even where arrangements are in place, practices can decline shared care requests on clinical or capacity grounds.

If I may, Ms Jardine, I will take the opportunity to update the House on the supply of medicines, which has also been raised by colleagues; I understand that it was raised at business questions recently, too. The Government recognise the difficulties that some people have experienced with accessing ADHD medication due to medicine supplies. We know how worrying and frustrating those shortages are for patients and families. I am pleased to say that we have resolved many of the outstanding issues affecting the supply of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution and guanfacine prolonged release tablets. However, some specific manufacturers continue to have issues with methylphenidate.

We continue to work with manufacturers to resolve remaining issues. In fact, I met the medicine supply team this morning, as I do very regularly, to make sure we are on top of these issues as much as we can be. The team is working hard to make sure that the situation improves. Where issues remain, we are directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to support continued growth in demand for the short and long term. We have worked with specialist clinicians during this time to provide comprehensive guidance to healthcare professionals where there is a disruption to supply. We keep the Specialist Pharmacy Service website up to date with the latest availability of ADHD medicines. I commend it to people listening to the debate and to hon. Members. It also provides comprehensive guidance on switching to alternative treatments, supporting clinicians to make informed choices with their patients.

I can assure colleagues that, as the Minister responsible for medicine supply, I will instruct officials to keep a close eye on this issue, so we do not see any of the progress we have made undone. I plan to hold an event, hopefully in Parliament and possibly in the autumn, to keep updating hon. Members on this issue, because I know it is one that concerns us all.

In closing, I want to address the young people who may be watching or tuning into the debate at home. I know it is tough for many neurodivergent kids today. You might be stuck on a waiting list, suffering at school or struggling to find your medicine. We really do care about this. We are trying to get to grips with some of the problems we found when we came into office, and I hope you will start to feel that progress within the next few years.

[Rachel Gilmour]

May I bring the Minister back to the subject of my earlier intervention? Will she, as a matter of urgency, take it up with the Home Secretary and get a decision? We should not discriminate against people with ADHD by preventing them from joining the services, whether it be the police, the Army, the Royal Navy or the RAF. I am so shocked about this I am like a dog with a bone—I cannot let it go.

[Karin Smyth]

I will ensure that the hon. Lady gets a reply on that issue.

I thank the hon. Member for Henley and Thame for securing this important debate and for giving me the chance to put on the record some of the issues the Government are addressing. The Government know there is much more to be done to get better access to timely diagnosis and support for all our constituents, but I hope the actions I have set out today provide some reassure to the hon. Gentleman and other colleagues.

Question put and agreed to.

Yeovil Hospital: Maternity Unit

Rachel Gilmour Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Adam Dance (Yeovil) (LD)]

I start by thanking the fantastic staff at Yeovil district hospital’s maternity unit and paediatric staff across the country for their hard work. I also thank the Minister for Secondary Care for coming to the Chamber this evening to respond to the issues raised, which are important for Yeovil and South Somerset.

In January, the Care Quality Commission inspected paediatric services at Yeovil district hospital. It issued a section 29A notice because it assessed that the hospital failed to meet regulations relating to staffing and governance, and therefore required significant improvement. On Monday 12 May, the hospital trust decided to temporarily close the special care baby unit at YDH from 19 May, initially for six months. That means that the hospital will also be unable to safely provide care during labour and birth at the maternity unit, meaning that the unit is effectively closed. Care of pregnant people due to give birth will now be transferred to Musgrove Park in Taunton, Dorchester county hospital, the Royal united hospital in Bath or Salisbury hospital.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I am sure that my hon. Friend knows about the problems that we have had at Tiverton district hospital. I was lucky enough to have had my three sons at the old Tiverton hospital. I am sure that people not being able to go to Yeovil hospital to give birth will push down—literally—into Tiverton hospital, but I remind my hon. Friend that there was an incident a couple of years ago when one of my constituents delivered her fifth child in a pub car park, because Tiverton hospital did not have the capacity to take her in. Does he agree that the closure of maternity services at Yeovil hospital impacts not just Dorset and Somerset, but the hospital in my constituency?

[Adam Dance]

I agree with my hon. Friend and I will come to that point later in my remarks.

In letters and at meetings, I have directly asked senior leaders at the trust for reassurance that the service will reopen after six months, but they have been unable to give it. My No. 1 priority is my constituents’ health and safety. I appreciate that the decision was difficult and that patient safety was at its heart. The safety of mothers and their babies must come first, but the way in which the decision was reached and implemented has been disgraceful. It has created huge fear and anger in Yeovil and may put people’s health at risk.

The hospital trust’s leadership team says that high levels of sickness among senior hospital staff caused gaps in the rota, but I have been informed that those staff are off sick because of work-related stress that was reportedly caused by a lack of support, a toxic work culture and bullying from management. That is not good enough. Clinicians have been working desperately hard to provide quality care and have been trying to work alongside management to improve the service, but they have found management to be unsupportive. It seems that the real issue is about management and about supporting and retaining staff.

After the CQC inspection, it was up to the hospital trust to plan a clear response and to ensure safe maternity services at Yeovil hospital. Despite money apparently not being a problem, there was a lacklustre attempt at recruitment and locums were brought in. The hospital leadership team waited until the last minute to reach a decision, and closed the maternity unit with little or no consultation with staff, patients and stakeholders, such as Somerset council and MPs like me. It is an insult that the hard-working staff knew about the closure only six days before it was due to happen. Some of them were told on Teams and others found out on social media—that is not how to treat staff.

It is a disgrace that expectant parents were given such short notice and that the hospital trust did not provide them with advanced and detailed information about the temporary closure. Yeovil hospital charity has been fundraising over the last few months for the maternity unit. It had already raised £2,000 and was due to have another huge fundraiser this month. The charity does great work for the hospital, but it too was left in the dark, which is not good enough.

It is especially worrying that a decision made to protect people may put their health at risk. Many expectant parents have told me about their fears about capacity at other hospitals and about travel times to Taunton, Dorchester or Bath. Last year there were approximately 1,300 births at Yeovil hospital. Most of the patients who would have been cared for at Yeovil hospital will go to Musgrove Park in Taunton, where staff have already raised concerns about not having enough capacity to manage their own patient numbers.