Pharmacies: Government Funding

Rachel Gilmour Excerpts

Wednesday 9th September 2026 Westminster Hall

[Sadik Al-Hassan]

I thank my hon. Friend for his work on the Select Committee. I agree with him. Pharmacy is well placed to help offer additional vaccination services as well as help with a suite of other minor ailments with an expanded Pharmacy First.

I greatly welcome the uplift for 2026-27 in the pharmacy contract, but let us be honest about the scale of the problem: funding fell by £800 million in real terms between 2015-16 and 2025-26, even as prescription volumes rose by 20%. Last year’s funding settlement was a great amount, but that has been eaten up by a great amount of costs, and the Government’s independent analysis found a £2 billion annual funding gap. Nationally we have lost nearly 1,500 pharmacies since 2017—a 15% contraction of the network. In my own constituency of North Somerset, that story is written in bricks and mortar. We have six fewer pharmacies than in 2016.

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

Last Friday I visited a community pharmacy in Tiverton, and it was announced on Monday that an application for another pharmacy in my constituency had been turned down. Currently I have three pharmacies in Tiverton when I actually need four. Does the hon. Member agree that we really need to grasp this nettle and make sure we have enough pharmacies on our high streets?

[Sadik Al-Hassan]

I share the hon. Member’s commitment to getting the right number of pharmacies for the population they serve. That is an important part of not just our high streets, but our communities. We must ensure we have pharmacy services available to people who need them, which reduces the pressure on the rest of the NHS system. The amazing pharmacies still working and dispensing in my constituency dispense over 109,000 prescriptions a month. They deliver thousands of Pharmacy First consultations and have saved as many as 7,370 GP appointments since January 2024.

I recently released my vision of what primary care should look like in 2040 and how we should integrate our system better. It has to be true integration, not just in words but in digital infrastructure. We need a primary care network that knows what happens in different parts of the provision, but also understands how that provision affects the rest of the NHS system. We need a true single patient record that extends beyond general practice and into pharmacy; that will make the funding decisions for the Department easier because we will be able to see the activity even better than we do today.

My message to the Minister is simple: pharmacies are not asking for charity. With some reports suggesting that only 14% of pharmacies are profitable, I am asking for money not to make the job of pharmacy easy, but to make it possible, because it should not be this hard. Pharmacists are asking to be paid properly for work they already do brilliantly. I urge the Government to set out a road map for a six-year funding settlement of £600 million in today’s terms, to invest in the workforce, to allow pharmacies to realise their ambition and finally to close the funding gap, before we lose any more of these vital neighbourhood services.

Community Hospitals

Rachel Gilmour Excerpts

Tuesday 16th June 2026 Westminster Hall

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

I thank my hon. Friend the Member for South Cotswolds (Dr Savage) for giving us all the opportunity to shine a spotlight on the challenges facing community hospitals, particularly in rural areas. Neighbourhood health and care in the community are the thrust of this Government’s health strategy. That is admirable and right, but good intentions alone are not a health strategy, and intentions mean very little if the infrastructure to deliver them does not exist. In constituencies like Tiverton and Minehead, it increasingly does not.

Let us take, for example, the removal of the CT scanner from Minehead community hospital. I have been stopped in the street more times than I can count by constituents expressing how big a blow that has been. The whole point of a scanner in Minehead was proximity—for it to be accessible to people across west Somerset who face long journeys to reach secondary care. Its removal is therefore curious, and a direct contradiction of the Government’s stated commitment to bring care closer to people. The strategy says one thing and the decisions say another.

It is not hard to understand why we are where we are. West Somerset is, in effect, a cul-de-sac, with limited transport, limited infrastructure and a long schlep to Musgrove Park hospital in Taunton for most things approaching secondary services. That has consequences beyond access; we are not an easy posting for healthcare workers either, precisely because of the geographic reality. There are no meaningful incentives attracting people to train and practise there, and there is no laser focus on local recruitment efforts, which I believe is our best bet. We live in a beautiful part of the world—it is true—but why would a newly qualified clinician choose a remote, poorly connected posting when better resourced options exist elsewhere? The south-west, as my colleagues know, is haemorrhaging healthcare capacity, and my constituency feels the effects acutely. Frankly, we are not being resourced as though those difficulties matter at all.

Every missed appointment is not just a missed check-up; it is a missed diagnosis. When people cannot reach care, conditions worsen. Some will inevitably end up in A&E, placing further pressure on an already stretched urgent care system, in a region with one of the country’s least accessible healthcare networks. We end up paying more for failure, and the approach has not acknowledged that an ounce of prevention is worth a pound of cure. When we talk of community care, it must reflect the needs of the community it serves. Rural areas tend to be older in demographic make-up, and healthcare provision is sparse. That cannot be treated as a marginal factor; it is the central planning reality. The rural premium in healthcare need is real, documented and consistently under-weighted in funding decisions.

My party has always been a proud champion of rural areas. We recognise the postcode lottery of care provision and the health inequalities it perpetuates. It is why we have called for the establishment of the strategic small surgeries fund, specifically designed to prop up buckling services in remote parts of the country and ensure that where someone lives does not determine the quality of care they receive.

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.