Health Services: Rural Areas

Sarah Dyke Excerpts

Wednesday 17th July 2024 Commons Chamber

[Jamie Stone]

The hon. Member makes his point with his customary charm. It is no wonder that he is so well liked in this place, because he always speaks for his constituents.

I have talked about the delays in vaccinations, which also applies to the lifesaving vaccinations that babies must have. The Scottish Government take a one-size-fits-all approach that, frankly, does not work in remote rural areas such as mine. The retention and recruitment of GPs and other healthcare workers is crucial, but poor wages and terms and conditions, and a lack of proper travel reimbursement, all lead to a general impression that the game is simply not worth the candle. That is why we are missing key workers and doctors, and why we are paying through the nose for locum and temporary staff. Madam Deputy Speaker, can you believe that NHS Highland has spent £21 million on locum staffing in the past year? That is almost 3% of its entire budget—an eye-watering sum. Could that money not have been spent much better, for example on care homes, hospitals or pain clinics that have been forced to close?

[Sarah Dyke (Glastonbury and Somerton) (LD)]

I apologise for coming a bit late to this debate. Primary care is asked to do more in rural areas than in urban settings, piling pressure on GPs, pharmacists and dentists, yet they struggle to recruit staff, as my hon. Friend said. A dental practice in Street, in my constituency, has been without an NHS dentist on its books for 18 months, despite its best efforts. Does my hon. Friend agree that we must explore ways in which we can incentivise healthcare professionals to practise in rural areas?

[Jamie Stone]

I absolutely endorse that. I am glad that I said in my opening remarks that my experience in a very remote part of Scotland applies to other parts of the United Kingdom. What we have just heard proves that this is the case.

NHS Scotland has halted all new builds and repairs to health centres across the entire country, which is another problem for healthcare. I have said already how big my constituency is. Just by commuting or doing house visits, healthcare staff will rack up 3,500 miles easily, because the distances are so great. At that point, their reimbursement per mile is more than halved, which does not encourage people to get involved. It is, in fact, discrimination against healthcare professionals who live in rural communities. Training is overwhelmingly based in urban areas, and there is very little incentive to get people to come and work in rural areas. Other factors, such as a lack of housing and job opportunities, feed into this problem.

There is another issue I want to raise: the lack of women’s health provision, which is pretty severe. In my maiden speech in 2017 I spoke about the need to restore maternity services to Caithness. Seven years later, that is more important than ever. Caithness general hospital used to have a consultant-led maternity service, which meant that expectant mothers could have their babies locally in the far north of Scotland. It was downgraded when I was my constituency’s Member of the Scottish Parliament. At that time, I had more influence and I got it restored. Since then, however, the maternity services have been downgraded again, and there appears to be no movement from the Scottish Government to reverse that. I wish that some Members from the party of the Scottish Government were present today.

Let me give an example of what this situation means: pregnant mothers have to make a 200-mile round trip in the car to deliver their babies. Imagine a trip like that in the middle of winter, and on rickety-rackety roads in the highlands. In 2019, a pair of twins were born—one was born in Golspie, and the other was born 50 miles away, in Inverness. It is a miracle that those children survived, and that neither a mother nor a child has perished. I have been calling for a safety audit all along, but there has never been one. We know perfectly well what the result would be: the arrangements would be deemed unsafe, if not a breach of human rights.

It is not just about maternity services; women’s health has been removed from the far north. A routine trip to see a gynaecologist and get a diagnosis for a life-threatening ovarian cyst, or for endometriosis, means travelling the same huge distance—if a woman is lucky enough to get an appointment before her condition has progressed too far for her safety. I wonder what we can do to encourage healthcare professionals to relocate to remote areas, because the health and wellbeing of their wives and daughters must surely be a factor when they consider moving.

For children growing up in the far north, it is no better. The waiting list for child and adolescent mental health assessments is three years. For neurodevelopmental screenings—for the diagnosis of dyslexia, autism, attention deficit hyperactivity disorder and so on—it is four years. That is the majority of their time at school. One family I spoke to during the election had waited 13 years for a diagnosis. That is a disaster. Dentistry has already been mentioned, and we know that intervention is crucial for long-term dental health