NHS Winter Readiness

Richard Foord Excerpts

Wednesday 30th October 2024 Westminster Hall

[Richard Foord (Honiton and Sidmouth) (LD)]

It is an honour to serve under your chairship, Sir Roger. I, too, pay tribute to my hon. Friend the Member for North Shropshire (Helen Morgan) for securing and speaking in this debate on a day when she, as the Liberal Democrat health spokesperson, has a lot else to do.

As we face another winter, our NHS is under severe strain. In east and mid Devon, where I am from, the situation is all too apparent. We have five community hospitals across Axminster, Honiton, Seaton, Ottery Saint Mary and Sidmouth, where we see hard-working staff do their absolute level best to deliver a whole range of vital services, such as audiology, X-ray and rheumatology. The hospitals have had their services reduced or even removed over time, which has led to the overburdening of the large acute hospitals.

The unfortunate reality is that the NHS is struggling in terms of acute hospitals like the Royal Devon and Exeter hospital in Exeter. The statistics in the south-west from last winter illustrate that well. Across Devon, 33% of patients in A&E waited more than four hours in February last winter, which is well above the national average. That means that rather than ambulances being out in the streets and lanes saving people’s lives, they spend 30 minutes or more waiting in queues outside, with 31% of ambulance arrivals at the RD&E last winter unable to offload patients in a timely manner. That might suggest to some that we need to put more money into ambulances and acute care, but that is not borne out in the research as the exclusive solution to the problem.

A King’s Fund report recently found that the failure to grow and invest in primary and community health and care services ranks as one of the most significant and long-running failures of health policy over the past 30 years. Today, we heard a Budget from the Government that pledges more funding for the NHS; we worry about what that might mean in respect of the absence of support for social care. Because the system is reactive, we spend increasing amounts on acute hospitals and crisis response rather than on the proactive primary and community care that could reduce hospital demand in the first place. That imbalance means that funding is funnelled into hospitals, where people go once they are very ill, and it leaves the community services that could prevent crises unable to do the preventive work they should be doing.

Our community hospitals in places like mid and east Devon are proof that effective healthcare is not just about big hospitals. I would like to see localised, specialised care that prevents and treats issues early and close to home. Community hospitals should offer more than just treatment; they are also about routine check-ups and screenings. They are places that people go to manage chronic conditions and to receive other ongoing care.

I stress that we have excellent healthcare staff in Devon—in the community hospitals, in primary care, in GP surgeries and in the acute hospitals—but year after year they are asked to do more with less. With more community-based teams, working closely with social care providers, we could avoid many of the delayed discharges we see in the acute hospitals. More than one in eight acute beds in England is essentially blocked, with 14,000 patients clogging the system. I do not mean to put it in those terms—I know that individuals filling acute beds because they are unable to be discharged sometimes feel like a burden, and I do not want that to be the case—but the fact of the matter is that there are acute beds that could be released for other needy patients.

Winter brings respiratory infections, flu and respiratory syncytial virus, all of which hit the elderly, the young and those with long-term health conditions the hardest. Flu vaccine uptake in the south-west is not where it needs to be, at only 46.5% last winter, and I urge people with long-term conditions to get vaccinated. When flu and other winter illnesses surge, the community health services and facilities can pick up some of the slack and reduce some of the pressure on hospital beds.

If we can shift to a focus on community help, it will be about preparation. I know it is challenging—it must be, or we would have done it in the last three decades—but we now need a concerted effort from national and local leaders to support that shift and support people in managing their own health before they are in crisis, so as to relieve the pressure on acute hospitals.

NHS: Independent Investigation

Richard Foord Excerpts

Thursday 12th September 2024 Commons Chamber

[Wes Streeting]

I am delighted to see my hon. Friend in her place. She might be from the wrong side of the river, but she is absolutely right about the importance of prioritising children’s health. As the Prime Minister said this morning, it is shocking that the No. 1 cause of hospital admission among children aged between six and 10 is tooth decay. I was criticised by the shadow Secretary of State, who said that I called our children “short and fat”; she is more outraged by my calling out the scourge of childhood obesity that her Government fuelled than she is by the scourge of child obesity itself. That is why we will act and why the Conservatives failed.

[Richard Foord (Honiton and Sidmouth) (LD)]

I welcome the fact that the Health Secretary talks about a shift from hospital to community care; that builds on Lord Darzi’s finding that 13% of beds are occupied by people who are waiting for care in more appropriate settings. Caring for patients in community hospitals is much more cost-effective than caring for patients in big acute hospitals like the Royal Devon and Exeter hospital where I live. What thought has the Secretary of State given to the use of community hospitals that have lost beds in the last decade, such as Seaton, Axminster, Honiton and Ottery St Mary?

[Wes Streeting]

The hon. Gentleman is absolutely right about the value of community hospitals, step-down accommodation and care close to people’s homes—or, better still, wherever possible, in their homes, so long as it is clinically safe and the right support and care is available. The shift from hospital to community will be at the heart of our 10-year plan for reform and modernisation. Like lots of his colleagues on the Liberal Democrat Benches and lots of those on the Government Benches behind me, the hon. Gentleman has already done a good job of putting his local lobbying of Ministers on the record in the House.

Unpaid Carers

Richard Foord Excerpts

Tuesday 3rd September 2024 Commons Chamber

[Richard Foord (Honiton and Sidmouth) (LD)]

Does my hon. Friend agree that one other Department that might be quite interested in a cross-Government strategy is the Treasury? My constituent Amanda had a civil penalty applied on the basis that she misrepresented her earnings, which has made her frightened to go back to work or to work more hours. Does my hon. Friend agree that it is damaging to the economy if we have people not going out to work?

[Wendy Chamberlain]

I agree with my hon. Friend. If the Government’s aim is to grow the economy, they must, in addition to other measures, be targeting those people who are economically inactive not because they cannot work as a result of their skills, knowledge or capacity, but because their caring responsibilities prevent them from doing so.

I am conscious of your direction, Madam Deputy Speaker, so if the House allows I intend not to take any further interventions. Otherwise, I will not get through the remarks that I want to make.

I want to mention Fife Young Carers, which supports 207 young people in North East Fife, and about 1,300 overall across Fife. Some of those carers are as young as five years old. Caring for a loved one as a child has a significant impact on their education. In the last Parliament, the all-party parliamentary group on young carers and young adult carers carried out an inquiry that found that young carers are missing on average 27 days of school each year and are 38% less likely to go to university than their peers. We know that how children do in school has a vital long-term impact on their future employment—indeed, the Education Secretary was talking about that the other day—and just about everything in their future. The position of young carers gives us a clear example of how the lack of an overarching strategy fails unpaid carers.

Earlier this year, I wanted to question the then Government over the exclusion of young carers from carer’s allowance, building on a question asked by the hon. Member for Slough (Mr Dhesi). The reason that the DWP gave me was that supposedly young carers in education can rely on educational grants for support. I therefore asked the Department for Education about support for young carers. It turns out that there is no specific support for them because they are not considered to be part of a vulnerable group. It means that the DWP can abandon financial support of young carers to the Department for Education, which seems to think that young carers can rely on their parents for income. That shows what happens and how support for arguably an incredibly vulnerable group can get lost without overall leadership.

Yet more Government Departments have a role in the health and wellbeing of unpaid carers. According to Carers UK’s 2023 state of caring report, 50% of unpaid carers are lonely and 58% of carers had to cut down on their hobbies and leisure activities. Caring for a loved one should not mean being isolated from your own support networks or having to give up the things that bring meaning and joy, but clearly it does for many, either because they cannot find the time in the day for themselves between work—if they can stay in it—and caring, or because often they simply cannot afford to participate any more. This is the moment for the Ministry of Housing, Communities and Local Government to get involved, with its overarching responsibility for leisure and the services provided at local level. I am talking about respite breaks, which the hon. Member for Strangford (Jim Shannon) mentioned, support services, and access to local leisure facilities. A cross-Government strategy could also engage the Scotland, Wales and Northern Ireland Offices, and ensure that similar priorities are discussed in intergovernmental meetings with the devolved nations.

There are many root causes and solutions to the problems faced by unpaid carers, and they span all Government Departments. The Minister is here as the Minister for Care, but I hope that he is also aware of the impact of all the cross-Government issues that I have set out on the health of unpaid carers. I am sure that he has learned much in recent weeks. Last year’s “State of Caring” report on health found that 82% of unpaid carers said that the impact of caring on their physical and mental health would be a challenge. It found a significant impact on mental health, with 79% saying that they were stressed or anxious and 49% saying that they were depressed. It is therefore no surprise that research carried out by Dr O’Dwyer at the University of Birmingham has found that unpaid carers are a group at high risk of suicide. That is particularly true for parent carers of children with a long-term illness or disability. Of the participants in her study, 41% of unpaid carers had thought about killing themselves.

It is clear that we need vital preventive healthcare for unpaid carers, but clearly that is not in the remit just of the Department of Health and Social Care. Again, I reiterate why we need a cross-Government strategy. I appreciate that even if a strategy were announced this evening, it would not just be in place overnight—it could not be and it should not be. Its goals need to be co-designed with unpaid carers and the organisations that represent them. It needs organisation, buy-in and leadership. For it to work and take meaningful action, it ought to be sponsored at the highest level of Government and engage all the Departments that I have mentioned. It needs ringfenced funding. It will not surprise the House that I have mentioned funding. The last strategy was supported by £255 million in funding. That may sound like a big figure when we keep being told that difficult decisions have to be made, but it is nothing compared with the economic value of unpaid care, which, as I have said, amounts to £190 billion per year.

I do not want to pre-empt the goals of the strategy—they need to be designed with unpaid carers themselves—but a first priority should be, as my hon. Friend the Member for Harrogate and Knaresborough said, the proper identification of unpaid carers. Unpaid carers may not recognise themselves as such or know what support services are available to them. Professionals and organisations play a vital role in identifying them, through GPs, hospitals, local authorities, workplaces and educational settings. A national carer’s strategy will provide leadership and strategic direction. It will put the needs of unpaid carers at the highest level of Government. Morally, practically and politically, it is the right thing for the Government to do.

I do not particularly like the title of this debate on the Order Paper. The word “potential” was inserted to keep me in line with the rules on neutrality in debate titles. It makes it sounds like the merits of the strategy are arguable, which clearly they are not. I chose to read “potential” in a different way: a national carer’s strategy has an abundance of potential to create improvements that have not yet been realised. I look forward to hearing the Minister’s remarks.