Healthcare in Rural Areas Debate
Full Debate: Read Full DebateRupa Huq
Main Page: Rupa Huq (Labour - Ealing Central and Acton)Department Debates - View all Rupa Huq's debates with the Department of Health and Social Care
(1 day, 13 hours ago)
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Several hon. Members rose—
This is a popular debate, so there will be a time limit of three minutes to begin with, but it might drop down. The first exemplar of perfect timing will be Samantha Niblett.
Several hon. Members rose—
Order. Potentially the final three-minute speech will be Henry Tufnell, and then we might have to drop the time limit to two minutes.
Several hon. Members rose—
We have done the maths; we can allow Members two minutes and 30 seconds.
It is a pleasure to serve under your chairship, Dr Huq. I congratulate the hon. Member for Mid Bedfordshire (Blake Stephenson) on securing this vital debate. I am also grateful to other hon. Members for making excellent contributions this afternoon.
We know that the NHS faces pressures all over the country, with rural communities experiencing unique health and wellbeing challenges shaped by geography, demography, infrastructure and access to services. Our 10-year health plan is a commitment to rewire our NHS, with the three shifts to improve access to healthcare for everyone—no matter where you live or how much you earn. Those three shifts—from hospital to community, sickness to prevention and analogue to digital—will support neighbourhood and community health services in getting the investment they need, and will greatly expand and improve access to digital services, bringing healthcare closer to everyone’s home.
The hon. Member focused quite a lot of his speech on our emerging neighbourhood health strategy. I will provide some further detail in response to some of his points. He highlighted the important differences between urban and rural. We recognise that neighbourhood services will need to look different across rural and urban areas to best meet the needs of each community. That is why their delivery will be locally led, with local systems determining how neighbourhood health is designed for their area. That work will start in the areas of greatest need, including rural towns and villages.
The hon. Member and others also asked about the definition of neighbourhoods in rural areas. First, neighbourhoods are natural communities that are recognisable by local residents. Secondly, neighbourhoods will typically have a population of around 50,000 people, but coherent geography is more important for defining neighbourhoods than population size. Thirdly, the geography of the neighbourhood will be determined locally by integrated care boards in partnership with their strategic partners, particularly local authorities.
The hon. Member also asked how rural areas will benefit from neighbourhood health. Neighbourhood health provides the unifying framework that will bring together what is already under way across primary care, community services, urgent care, prevention, digital, estates and population health more broadly. The neighbourhood health service will make it easier for people to access care closer to where they live, including in neighbourhood health centres. Delivery will be locally led, with systems determining how neighbourhood health is designed to meet local population need. That will factor in how services may need to look different across rural and urban areas.
The neighbourhood health service will also move us towards a fully digitally enabled health service. We are striving for digital services to improve access, experiences and outcomes for the widest range of people based on their preferences, as any digital healthcare benefit will be limited if people remain digitally excluded. We are working closely with the Department for Science, Innovation and Technology on the issues raised around improving access to broadband.
To deliver neighbourhood health services, the 10-year health plan introduces two new contracts, including one to create multi-neighbourhood providers covering populations of around 250,000 people. That will unlock the advantages and efficiencies possible from greater-scale working across all GP practices and small neighbourhood providers within the footprint. We will start in the areas of greatest need where healthy life expectancy is lowest, which includes rural towns. By targeting places where healthy life expectancy is lowest, we will deliver healthcare closer to home for those who need it most. Neighbourhood health plans will also be drawn up by local government, the NHS and its partners. The integrated care board will bring those together into a population health improvement plan for its footprint and will use that to inform commissioning decisions.
The medium-term planning framework, covering 2026-27 to 2028-29, sets out proposals for the further use of advice and guidance, asking systems to ensure all referrals go through a single point of access. That delivers a robust approach to triage so that patients are cared for closer to home, and there are fewer out-patient appointments in secondary care. That framework will also require a significant reduction in the number of clinically unnecessary follow-ups.
Turning to general practice, which came up a lot in the debate, we absolutely recognise the challenges facing rural communities in accessing GP services. We are expanding capacity across England, including to the areas that need it most. We are investing over £480 million extra into GP services this year, including investment in the primary care workforce, ensuring places like Mid Bedfordshire get the resources and GPs that they need.
Since October 2024, we have invested £160 million into the additional roles reimbursement scheme, which has supported the recruitment of over 2,000 GPs—smashing our manifesto pledge of 1,000 additional GPs. Furthermore, the introduction of a practice-level GP reimbursement scheme, worth £292 million, will enable practices to hire additional GPs or fund extra sessions with existing GPs. We are also seeing the results of those broad efforts. I am absolutely delighted that patient satisfaction has risen by over 15% since July 2024, from 60% to 75%, and an additional 6.8 million GP appointments have been delivered compared with the same period last year.
We know that patients are struggling to access NHS dentistry services, particularly in rural areas. To address that, we are reforming the dental contract to match resources to need and to improve access. As a first step, our 2026 reforms are focused on improving the dental contract to deliver the right care to the right people, including those in rural areas, while incentivising NHS dentists to provide more NHS care, with additional urgent appointments and new pathways for patients with complex needs. We are also continuing to recruit dentists under the golden hello scheme, which offers dentists £20,000 to work in underserved areas.
Urgent and emergency care is also a challenge for rural areas. We are ensuring that the country gets the care it needs, when it needs it. We launched our urgent and emergency care plan for 2025-26, supported by a substantial £450 million of capital investment. That will enable the upgrade of hundreds of ambulances and the expansion of urgent and emergency care capacity, reducing A&E wait times and getting more ambulances back on the road, more quickly.
Rural adult social care services are really important. Local authorities are responsible for shaping their care markets to meet the diverse needs of local people. However, the Government are also committed to ensuring adult social care funding reflects the costs that different communities face, which is why we have updated the formula used to distribute funding for adult social care to local authorities to include a remoteness adjustment. That means that the funding distribution better reflects the cost of providing care in different parts of the country. To give the local picture in the constituency of the hon. Member for Mid Bedfordshire, between 2025-26 and 2028-29, central Bedfordshire is set to see its notional allocation for adult social care services increase by £11.3 million, which is more than a 7% cash increase above budgeted adult social care spend.
I want to say a quick word on finance. To support remote or sparsely populated areas, the ICB target allocations formula includes an emergency ambulance cost adjustment to reflect longer travel times in sparsely populated areas; a travel time adjustment to the community services formula to reflect the additional time it takes patients to travel between appointments in sparsely populated areas; and an adjustment to support hospitals with 24-hour A&E services that are remote from the wider hospital network and have unavoidably higher costs. Those adjustments help to support rural communities in accessing the health services that they need.
I hope that I have managed to touch on some of the issues raised. It is a wide-ranging topic because rural healthcare, by definition, requires many different services. We absolutely recognise the challenges, and we recognise that we still have a mountain to climb before we can get our NHS back on its feet and fit for the future.
We believe that through the three shifts—from hospital to community, treatment to prevention and analogue to digital—and the strategies that we are pushing through on workforce, digital, better support for general practice, and neighbourhood health, we can get our NHS back on its feet and fit for the future. Once again, I thank all hon. Members present and I congratulate the hon. Member for Mid Bedfordshire on securing this debate.