Health Services: Cross-border Co-operation

Virginia Crosbie Excerpts

Tuesday 16th April 2024 Westminster Hall

[Dame Caroline Dinenage (in the Chair)]

I will call Virginia Crosbie to move the motion and then I will call the Minister to respond. As is the convention for 30-minute debates, there will not be an opportunity for the Member in charge to wind up, or indeed for anyone else to make a speech, but there will potentially be opportunities to intervene.

[Virginia Crosbie (Ynys Môn) (Con)]

I beg to move,

That this House has considered cross-border cooperation on health services.

It is an honour to have you chairing this important debate on cross-border co-operation on the health service, Dame Caroline, and I thank you for the opportunity to hold it.

My constituents in Ynys Môn, like those of my colleagues here today, are served by the devolved Welsh NHS, which is managed and funded by the Welsh Government in Cardiff. Despite health having been devolved for 25 years, around a third of my most serious casework is for my constituents who are suffering, or perhaps even dying, because of failures in our local health board. I hear from patients, families and even members of staff who are deeply concerned about Betsi Cadwaladr University Health Board—BCUHB for short—and the effect that its failings are having on the people of north Wales. That is why my colleagues and I want the UK Government to help find a solution and why we desperately need the following: much better co-operation across borders on our health services; data that allows the direct comparison of performance across all health boards in the UK, regardless of whether they are devolved; a recognition that the UK Government have a moral, and arguably a legal, duty to take action where the wellbeing of their citizens is compromised; and a willingness to act on that duty where necessary.

I can best explain why we are so concerned by sharing the issues we face in north Wales. BCUHB is by far the largest health board in Wales; with a budget of £1.9 billion, it is responsible for a quarter of the Welsh population—more than 700,000 people spread across a huge area roughly four times the size of Greater London. BCUHB is currently in Welsh Government special measures for not the first but the second time; it has spent all of the last six years in special measures. Despite that, its performance seems to be getting worse, not better. It has been called “dysfunctional”, “chaotic” and a “basket case”. In February 2023, the Welsh Health Minister sacked its entire board. An audit of its 2021-22 accounts found £122 million unaccounted for, with senior executives accused of deliberately falsifying entries. It is now on its eighth chief executive in 11 years. All that is despite a devolution settlement that funds the Welsh Government with £1.20 per person for every £1 we spend here in England.

It is difficult to relate just how bad some of the stories I hear are: people discharged from hospital sicker than when they went in; hours spent waiting for ambulances, and hours spent waiting in ambulances outside A&E; errors in patient records; appointments lost; significant failures in the provision of medication; palliative patients dying in hospital because fast-tracking them home would take weeks; and medical appointments cancelled and rearranged for hospitals 60 miles away.

[Dr James Davies (Vale of Clwyd) (Con)]

I congratulate my hon. Friend on securing this important debate. Betsi Cadwaladr University Health Board has, over the last decade, received the 11th highest number of prevention of future death reports of any organisation in England and Wales. To put that in perspective, organisations with comparable numbers of such reports are generally whole United Kingdom Government Departments. Does my hon. Friend agree that that is a damning indictment of the poor state of health services in north Wales and further emphasises the serious concerns about the adequacy of those devolved services?

[Virginia Crosbie]

I thank my hon. Friend for his intervention, which gives me the opportunity to thank him for his hard work in fighting not only for his constituents, but for everyone across Wales. They deserve a better service than they are getting, and it is only by working together that we can get action, so I am delighted that he is here today. He is a doughty campaigner and a doughty champion for his constituency.

[Jim Shannon (Strangford) (DUP)]

The Northern Ireland-Republic of Ireland cross-border initiative was officially closed in December 2020 due to the withdrawal of EU funding. It was a scheme that many of my constituents bought into and did well out of, getting their operations down south before coming back to Northern Ireland, thereby skipping long waiting lists.

The hon. Lady is absolutely right to ask for better cross-border health co-operation between Wales and England, and I understand the reason that she does so, but I believe that there is an argument to be made for a scheme across the whole United Kingdom of Great Britain and Northern Ireland, because I think that there are cross-border opportunities that we can all take advantage of. Although she is asking specifically about Wales and England, the title of the debate, if she does not mind my saying so, is “Health Services: Cross-border Co-operation,” and that is something that we can all ask for.

[Virginia Crosbie]

I thank the hon. Member for his intervention, and in particular for that feedback on how cross-border co-operation actually works. Of course I am focusing on Wales, but he quite rightly highlights that this is the United Kingdom. By working together, we can solve these issues and provide a collaborative approach to healthcare for people across the UK.

I also wanted to add to my list of failures the near-collapse of local NHS dental services. I could honestly stand here and reel off story after story of lives drastically and sometimes irreversibly impacted by the failures of BCUHB. In Holyhead, the largest town in my constituency, two GP practices were merged during the pandemic into Hwb Iechyd Cybi, or Cybi Health Hub. That practice has suffered a series of problems, including twice facing the threat of having no GPs—and that is in Holyhead, the largest town in my constituency.

One of the main things that would make a difference to Hwb Iechyd Cybi and the people it serves would be to co-locate the two original practices. Proposals have been made for that and, in the longer term, for a state-of-the-art healthcare centre for Holyhead. The co-location project would deliver economies of scale that would vastly improve the service that the practices can deliver and, therefore, patient outcomes. The project was allegedly given the go-ahead two years ago, but it has stalled and stalled in BCUHB’s hands, and now it has completely stagnated. Likewise, the integrated health centre has been under discussion for years, but it remains under discussion, with no progress likely. Lack of funding is the problem that is generally cited.

Hwb Iechyd Cybi serves 9,000 patients, and there are around 15,000 people in its catchment area. Holyhead is not a minor backwater in north Wales; it is a large town, yet it has no integrated healthcare. It has an A&E that is 25 miles away across a bridge that closes in high winds, and it has a massive shortage of doctors. I have launched my own petition to raise awareness of this issue and to call on BCUHB to proceed with the co-location project, as well as starting work on the new health centre with urgency. I recognise that the NHS faces significant pressures across the UK, but people are actually moving out of my constituency to live in other parts of Britain because they are scared of becoming ill in north Wales.

There are too many stories of avoidable death and harm. Unfortunately, it is almost impossible to compare the situation across the devolved nations in order to see just how bad it really is, because the Welsh Government produce different data from that produced by the UK Government. That makes it almost impossible to compare patient outcomes across borders.

What we do know are facts like these. In 2023, over 22,000 paramedic hours were lost in Wales just waiting outside A&E. In January 2024, more than 3,000 people in north Wales waited for more than 12 hours to be discharged from A&E, and nearly 60,000 BCUHB patients had been waiting for more than 36 weeks to start treatment; six years earlier, that number was just under 10,000. Over 57,000 people across Wales have been waiting for more than a year to start treatment, with 24,000 patient pathways waiting more than two years. Since 2010-11, the Welsh Government have increased health spending by 30.6%, well short of the UK Government’s increase in England of 38.9%.

We have asked the UK Government for help on behalf of our constituents. Last year, the then Secretary of State for Health and Social Care, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), wrote to the Welsh Government to offer a right of access to NHS services in England for people in Wales. Unfortunately, the Welsh Health Minister claims not to have the additional budget to facilitate that proposal, despite the clear benefits it could offer our constituents. The Welsh Government can, however, find an estimated £100 million to increase the number of Senedd Members from 60 to 96; £4.25 million to buy a farm that it now cannot develop; and over £30 million to implement the much-derided default 20 mph speed limit.

The Welsh Government approach is also highly inconsistent. Take the covid pandemic. The Welsh Government seemed to be unaware that they would have to provide their own response to the threat, despite having been in charge of healthcare in Wales for years. They prevaricated and created different measures and responses, but they want to be part of the UK covid inquiry rather than holding their own. They seem to think they can pick and choose when they are accountable. It would be fantastic to see the Welsh Government prioritising health as the UK Government are doing, for example by enabling pharmacies in England to prescribe medication for common conditions such as earache and impetigo. It is challenging to be a UK MP in Wales when a matter such as health is devolved. Many people do not realise that it is devolved and blame Westminster for failings.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

The hon. Member is making an splendid speech, and my goodness, it rings a bell with me. I have a GP friend in Caithness who developed an aggressive cataract; within a very short space of time she was unable to drive and had to give up her practice. She put her name down with NHS Scotland. Shortly afterwards, she went private and got it dealt with. Fourteen months later, she got a message from the NHS to say she could have a consultation —not a treatment, but a consultation. She would have grabbed it with both hands if she could have got treatment across the border in England. There is a lot wrong with the NHS in Scotland. It is too bad that none of the nationalists are here. They should be pressing for cross-border co-operation as well. Let us hope we get it.

[Virginia Crosbie]

I thank the hon. Member for sharing some background information on the situation in Scotland and his friend’s story of waiting 14 months for a cataract consultation. He makes a very important point: there should be many more Members of Parliament here for the debate. We have the Minister here, and it is an important opportunity to share some of the some of the terrible stories that we hear.

Despite health in Wales not being our gig, it makes up a third of my postbag, and my colleagues and I cannot turn our backs on our constituents. We cannot ignore their problems and blame Wales, because these are life and death situations. We desperately need the UK Government to step in and up the ante on cross-border co-operation. We desperately need the UK Government to take this matter in hand and do something now to protect the wellbeing of British citizens. Will my right hon. Friend the Minister commit to visiting Ynys Môn and meeting my constituents who have suffered as a result of the BCUHB failures and those who desperately need an integrated medical centre in Holyhead?

NHS Dentistry

Virginia Crosbie Excerpts

Tuesday 9th January 2024 Commons Chamber

[Victoria Atkins]

I will resist, but only because I am going to ask the hon. Gentleman to intervene in a moment—he should be careful what he wishes for. I also notice that he talked about reform of the dental contract but did not give any detail. Government is not as easy as selling a book. It cannot be cut and pasted from Wikipedia, as some on the Labour Front Bench seem to like to do. It is about being clear on what you would do differently. Now, Labour in Wales is of course running the Welsh NHS. They do like to do things differently. People there are almost twice as likely to be waiting for health treatment as in England.

[Virginia Crosbie (Ynys Môn) (Con)]

The Leader of the Opposition states that the Labour Government in Wales is a blueprint for what Labour can do in the UK. Given that 97% of high street dentists in Wales state that Labour’s reforms are not working, does the Secretary of State agree that NHS dentistry is being destroyed by Labour in Wales, and that if Wales is their blueprint for UK dentistry, we should all be very afraid?

[Victoria Atkins]

I thank my hon. Friend, who represents a Welsh constituency. The chair of the British Dental Association wrote to the Labour Welsh Government to complain about their plan and, I understand, used words such as “toxic mix of underinvestment” and “untested targets.” The picture in Wales, if it is the Leader of the Opposition’s blueprint, is perhaps not as convincing as the shadow Health Secretary would have us believe.

The fundamental difference between the current systems in England and Labour-run Wales is that Wales has a capitated list system for dentistry. I am willing to give way so that the shadow Health Secretary can clarify whether he wants to bring in that system.

Oral Answers to Questions

Virginia Crosbie Excerpts

Tuesday 17th October 2023 Commons Chamber

[Helen Whately]

NHS England determines the funding received by integrated care systems. That follows a formula which takes into account the needs of local populations, demographic deprivation and so on, and ICSs are then able to direct resources as they are best needed across those populations. Part of their value, and part of the intention in setting them up along with the organisations within them, lies in that ability to understand the health needs of local populations and direct resources accordingly.

[Virginia Crosbie (Ynys Môn) (Con)]

Integrated care systems bring partner organisations together to improve health, tackle inequalities, and enhance value for money. Detailed data such as that produced by NHS Digital is critical to their work, but we learnt this week that A&E waiting times in Wales had been under-reported for the last 10 years. Does the Minister agree that without accurate data, the Labour Government in Cardiff are scuppering the attempts of NHS Wales to deliver better health outcomes throughout Wales?

[Helen Whately]

My hon. Friend has made a good point about the importance of transparency and accurate data. As she said, just this week we learnt that Labour-run NHS Wales had been under-reporting its A&E waiting times. According to the Royal College of Emergency Medicine, about 45,000 patients are missing from the data. While we are working hard to improve services in the NHS in England, the Labour-run NHS in Wales is merely fudging the figures.

Oral Answers to Questions

Virginia Crosbie Excerpts

Tuesday 11th July 2023 Commons Chamber

[Neil O’Brien]

I have looked carefully at that case, on which the hon. Gentleman has been campaigning. The incumbent provider chose not to bid for the future contract for Park View medical centre, and NHS Cheshire and Merseyside decided that the best thing was to help patients to transfer to neighbouring practices. Patients will only be transferred to practices rated as good, and there are 10 other practices rated as good within a 1-mile radius of Park View. Since 2019, there has been an increase in the number of patient-facing staff of about 50% in the constituency. That means there are more people in his GP surgeries. We are working hard to ensure high-quality GP services in his constituency.

[Virginia Crosbie (Ynys Môn) (Con)]

Health is devolved to Labour in Cardiff. Ynys Môn is represented by five Members of the Senedd, yet health represents a third of my postbag, particularly relating to access to primary care in Holyhead. Does the Minister agree that families in Holyhead are not getting the healthcare they need and deserve?

[Neil O’Brien]

Yes, it is true, I am afraid. People are about twice as likely to be waiting for treatment in the Welsh NHS. Waits are also longer in Wales, with 30,000 people waiting more than two years for treatment, even though those have been eliminated in England. England spends more on general practice than Scotland or Wales, despite the fact that Wales has 20% more funding, and England has also grown spending on general practice faster than either Scotland or Wales. We are highly focused on getting good primary care services in England. There are always lessons that we can learn from each other, but there are definitely lessons that Welsh Labour can learn from the English NHS.

Defibrillators: Public Access

Virginia Crosbie Excerpts

Tuesday 4th July 2023 Westminster Hall

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I beg to move,

That this House has considered public access to defibrillators.

It is a pleasure to serve under your chairship, Sir Charles. I am bringing this motion before the House this afternoon to maintain the steady pressure from campaigners and parliamentarians in relation to increasing awareness of and knowledge about defibrillators in two key regards: one, where they are; and two, how to use them. This continues the fine work conducted by Members from across this House, including the members of the all-party parliamentary group on defibrillators, its chair—the hon. Member for Stoke-on-Trent North (Jonathan Gullis) —and the hon. Member for Strangford (Jim Shannon), as well as Members of the other place.

This issue was brought home to me by the experience of my constituent, Bonnie McGhee, who works in the cardiology unit at Queen Elizabeth Hospital. Sadly, Bonnie lost her father to a cardiac arrest, but has since successfully raised funds for a defibrillator in his memory. Access to a defibrillator may have saved his life. The defibrillator that Bonnie funded is in the Clockhouse Community Centre in memory of her father, Jeffrey Anthony Mee. I think of Bonnie and her late father often, and today, they are especially in my thoughts.

In the UK, one person dies every three minutes from a heart or circulatory disease and, every year, 60,000 out-of-hospital cardiac arrests occur. Research by the National Institute for Health and Care Research found that only 8% of people suffering a heart attack outside of hospital will survive. However, the same research found that the odds of survival increase to 32% if a member of the public has access to an automated external defibrillator. If someone has access to a public defibrillator and can administer a life-saving electric shock to the heart to restore its normal rhythm, that will improve the likelihood of survival for anyone who has had a cardiac arrest.

Defibrillators represent an incredible technical advance. They are lightweight, easy to use and designed only to help and not harm the patient. The issue is not about their design but their distribution and public awareness of what they are and how to use them.

[Virginia Crosbie (Ynys Môn) (Con)]

I thank the hon. Member for securing this important debate and for her excellent speech. Does she agree that community defibrillator training sessions are vital, and will she join me in thanking people such as Ryan Cawsey of St John Ambulance Cymru and Stephanie Roberts of the Gwalchmai Hotel, who make possible free defibrillator training sessions for Ynys Môn constituents?

[Abena Oppong-Asare]

I thank the hon. Member for her intervention, and I will come to that really important point about community training. I also thank her and agree with her comments about the charities and organisations that are already doing the groundwork to provide help and ensure that people are adequately trained.

Research from Resuscitation Council UK shows that access to AEDs is not fairly distributed across the income and ethnic distribution of England. In other words, if someone is poor and/or black, they are less likely to have access to a defibrillator, but if someone is affluent and white, they are more likely to have access. The research shows unequal access across England, with fewer in the north-east and more in London. This is a classic example of what Dr Tudor Hart called “inverse care law”, whereby people with the most needs get the least provision, and vice versa. I hope that the Minister can address that point and tell us what the Government are doing to tackle these stark examples of health inequality.

Oral Answers to Questions

Virginia Crosbie Excerpts

Tuesday 6th June 2023 Commons Chamber

[Virginia Crosbie (Ynys Môn) (Con)]

Does the Minister agree that one of the ways we can improve cancer care and outcomes is by supporting brilliant charities such as Chemocare Bags? Emma Hart and her team do an outstanding job of putting together bags, which include fluffy socks, puzzle books, colouring books, mints and lip salve, for those starting chemotherapy at Ysbyty Gwynedd in Bangor.

[Steve Barclay]

I am very happy to join my hon. Friend in paying tribute to all those who support Chemocare Bags for the fantastic work they do. That sort of support makes a real difference to patients, and the NHS benefits hugely from the work of volunteers, including those at Chemocare Bags.

Oral Answers to Questions

Virginia Crosbie Excerpts

Tuesday 6th December 2022 Commons Chamber

[Steve Barclay]

It is worth reminding the House that there are 3% more doctors this year than last year. As I have said, we have 2,300 more full-time GPs, and we are recruiting more. However, the hon. Lady is absolutely right about doctors’ pensions; that is a material issue, which is why we launched the consultation, and we are working with Treasury colleagues to address these concerns as quickly as possible.

[Virginia Crosbie (Ynys Môn) (Con)]

GP numbers are falling in Wales. Healthcare is devolved to the Welsh Labour Government, and although Ynys Môn is represented by five members of the Senedd in Cardiff, healthcare concerns constitute a staggering 25% of my postbag. Does the Secretary of State agree that families throughout Wales are not receiving the healthcare that they need and deserve from the Welsh Labour Government?

[Steve Barclay]

I do agree with my hon. Friend, and I think it would help the House to assess the performance of the Welsh Government if there were more transparency. For instance, the Opposition motion on today’s Order Paper refers to vacancies in England. I am sure it will surprise the House to learn that the Welsh Government stopped collecting statistics for workforce vacancies in 2011. I look forward to Opposition Members’ encouraging their Welsh colleagues to be more transparent.

Health Incentives Scheme

Virginia Crosbie Excerpts

Friday 22nd October 2021 Commons Chamber

[Maggie Throup]

I am here today to talk about this pilot and how it will be taken forward, which is exciting news. This will be across the population to ensure that a mixture of people take part: different ages, males and females. That is so important. Some of the information from that will help us to look at policies in the future. There are good programmes to engage young women in sports. When female football teams or tennis players do very well that encourages even more people to take up sports—not just women but across the board. Such successes will help to tackle obesity in a soft way.

[Virginia Crosbie (Ynys Môn) (Con)]

I thank the Minister and welcome her news about this important pilot. Eating disorders can be devastating for so many families. On behalf of those families, can my hon. Friend confirm that the focus of this scheme is not weight loss, but encouraging people to adopt a healthier lifestyle?

[Maggie Throup]

My hon. Friend is exactly right. This is not stigmatising anybody. It is not about weight loss; it is about healthy choices and empowering individuals.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

Virginia Crosbie Excerpts

2nd reading & 2nd reading: House of Commons
Friday 16th October 2020 Commons Chamber

[Sally-Ann Hart (Hastings and Rye) (Con)]

It is a pleasure to be able to speak in this debate. I congratulate my hon. Friend the Member for Sevenoaks (Laura Trott) on bringing this Bill to the House.

My hon. Friends have looked back to their childhoods. I grew up in a family of girls; I had three sisters growing up, and our parents were absolutely fantastic. My mother was amazing—I do not know quite how she managed four girls growing up, with all those hormones raging, but she did—and so was my father. I want to emphasise to all hon. Gentlemen in the House how important it is for girls to have fathers who are encouraging, who tell them they are gorgeous but do not focus only on their looks, who tell them how important education is, and who bring them up with confidence and substance. I thank my parents for the job they did with their four daughters.

The 2017 Conservative manifesto contained a commitment to ensure effective registration and regulation of those performing cosmetic interventions. At present, practitioners of botox or fillers do not need to be medically qualified to perform the procedures, and there is no mandatory competency or qualification frameworks related to their administration. The potential health risks of such procedures include blindness, tissue necrosis and all the things highlighted by other hon. Members.

In 2008, the British Association of Plastic, Reconstructive and Aesthetic Surgeons said that cosmetic surgery should always be conducted in the patient’s best interest. It said that the decision to perform plastic surgery on a teenager should be made only in exceptional circumstances and with parental consent. That type of scrutiny should also apply to beauty and cosmetic treatment practitioners. Although it is normal for teenagers to worry about their looks, it should never be a matter of course for young people to have or to consider cosmetic or aesthetic surgery unless it is for medical reasons. Surgeons work under strict guidelines, and it is their responsibility to weigh up the pros and cons for each person in a responsible and focused manner, in the best interests of their patient.

[Virginia Crosbie (Ynys Môn) (Con)]

As a teenager, I had a terrible car crash. We have all been looking back at our childhoods. I had a fantastic plastic surgeon—Brian Sommerlad—and I have had the opportunity to thank him and his team in this Chamber. Does my hon. Friend agree that, for medical reasons, we should have support for people at that very vulnerable time?