Helen Morgan MP: speeches 2024

Speeches

• 5 Nov 2024 · Income Tax (Charge) · Hansard source

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  I thank the hon. Gentleman for his intervention. The point that we are trying to make is that some of the Budget measures will cost extra money. If we look at the detail on the national insurance contributions hike, for example, we see that changes in behaviour and exemptions for the NHS will reduce the amount of money raised to about £10 billion. We have absolutely put forward alternative measures to raise £10 billion. Whether by reversing the Tories’ cuts to the banking taxes or by putting taxes on online media giants, we would find alternative ways to raise those funds. The point about private school fees is the same. If we overburden the state sector with children who have special educational needs, difficulties and disabilities, those children will not have their needs met, and that will cost us more in the future. This is all about making sensible choices to save taxpayer money in the future and, most importantly, delivering public services to the people who need them most, whether they are trying to access NHS care or whether they need help to get through their school career in order to thrive and achieve their potential.

• 5 Nov 2024 · Income Tax (Charge) · Hansard source

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  I am just about to conclude, so I will carry on. I was about to talk about farmers and the concerning differences between DEFRA and the Treasury on the number of farms that will be affected. My sense from talking to farmers locally is that the DEFRA numbers are more likely to be accurate, and I therefore think there may have been a serious misstep in the plan to raise what will be a relatively small amount of money. Liberal Democrats welcome investment in the NHS. We welcome the ambition to undo the damage wrought on this vital service by the previous Government, but we are concerned that, in social care in particular, we are in danger of kicking a thorny problem down the road. We urge the Government to consider immediate cross-party talks on funding social care and providing a long-term solution. We are also really worried about the impact of increased national insurance contributions on key providers outside hospitals. We cannot have GPS going out of business because of a Government measure that was intended to improve and expand their services. My constituents were fed up with being taken for granted by the Conservatives and they voted emphatically to change that situation, but I am sure that they are very worried that they are about to be ignored by Labour. I urge the Government to rethink their damaging policies on national insurance contributions and the care sector, to have another look at the impact of the Budget on family farms, which I think may have been underestimated, and to back the infrastructure that rural areas need.

• 4 Nov 2024 · Budget: Implications for Farming Communities · Hansard source

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  One of many emails I have received in the past week is from a farmer who has an archetypal family farm of 330 acres of mixed dairy and arable that they are planning on passing on to their son, even though they are struggling to make ends meet. He is typical of farmers in my constituency, and he is very concerned. We have not seen any investment in public transport or any of the other sweeteners that the Minister mentioned earlier. Can he explain what investment will go into rural transport, and why he has set the threshold for APR so low?

• 30 Oct 2024 · NHS Winter Readiness · Hansard source

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  I beg to move, That this House has considered NHS readiness for winter 2024-25. It is a pleasure to serve with you in the Chair, Sir Roger, and I am grateful to have secured a debate on the crucial topic of preparing the NHS for winter. This is particularly timely on a day when the Government have delivered the Budget and outlined their priorities for the coming year, and indeed, the years after that. We all know that due to the Conservative failure to protect the NHS, winter is a time when pressure on the NHS peaks. Every year, we suffer what we describe as a winter crisis. But for the millions of people stuck on waiting lists, the thousands of people treated in corridors and the legions of staff battling to keep people safe, it must feel like the winter pressure never ends. I am sure we would all agree that the health and care crisis requires long-term action—improving public health, focusing on primary care, training and retaining more doctors, dentists and nurses, fixing the crumbling NHS estate, and fundamentally, finally addressing the crisis in social care. But while we wait for that action, winter is now looming. The clocks have gone back and time to prepare for winter has run out. I am here to find out what the Government are doing both to get the NHS through the upcoming winter and, following the Budget statement, to get the NHS ready for the winters to come. I am aware that the Chancellor has just announced a £22 billion cash injection into the NHS, although further detail on that was scant, so we will put forward our ideas in this debate and hope that they come to fruition over the next few weeks. For the sake of staff and patients, it is crucial that winter crises become a thing of the past. We have reached the point where winter pressure is normal all year around. We should be striving for the reverse, where pressure is relieved and the forecasted crisis does not happen. I am pleased to hear some of the measures that the Government have outlined today, but I remain worried that fundamental issues are still being ignored—most crucially, the crisis in social care. Until that is resolved, we will not be able to fix the NHS. So what is the state of play? Dr John Dean, the clinical vice-president of the Royal College of Physicians, warned that the latest NHS statistics show the health service “is in an extremely concerning position as we head into winter.” He is not alone in holding such concerns, for it has already been a really busy year for the NHS. In fact, it has been the busiest ever summer for A&E departments in England, with NHS staff managing 6.8 million attendances in just the past three months, according to a briefing by NHS England on readiness for winter. Last month, emergency departments had 2.2 million attendances—the highest such number for a September on record—with more than 38,000 people waiting longer than 12 hours after the decision to admit them. Meanwhile, the weekly average of extra bed days for patients remaining in hospital beyond seven days due to delays in discharge was the highest since December 2022. A look at my local hospital trust in Shropshire illustrates the situation well. In Shropshire, at the Shrewsbury and Telford hospital NHS trust, our bed occupancy rate is constantly around the 95% mark. That is not unusual; it has become the norm at acute hospital trusts up and down the country, and not just in winter, but all year around. Hospital staff constantly have to juggle resources to try to secure people the care they need. As the wards fill up, A&E becomes crowded and care moves on to corridors. Every month, I am contacted by constituents who are shocked by what they have encountered in the hospital: being forced to wait for hours in pain on plastic chairs, or having their dignity taken away as they occupy a trolley in a corridor, in agony and in full view of the public. Many people remain unaware of how common that is until they find themselves with a loved one in that situation. The “Dispatches” documentary filmed at Shrewsbury and Telford hospital trust earlier this year brought the reality home to the nation. The issues with hygiene and infection control were startling enough on their own—I am pleased that the trust is addressing those directly—but most stark was the human impact on the patients. Scenes included that of the elderly man who was forced to urinate while on a trolley in a corridor, in full view of staff, or the woman who cried out in agony for hours, with staff being left in despair at the terrible situation they were trying to deal with. That was not in the depths of winter; it was in April and May. Corridor care takes a toll on patients and a huge toll on the staff who are forced to attempt to cope. However, the full scale and the impact of corridor care are unknown, because there is only patchy reporting on the level of care in temporary environments. As we seek to better understand and prepare for pressure in the winter, and all year round, will the Government consider mandating the recording and publishing of the number of patients receiving care in temporary environments, such as corridors? Honesty and transparency are key if we are to properly prepare for the winters to come. Every month, more than 2,000 patients spend more than 12 hours in the A&E department at Shrewsbury and Telford, and one in every three of the many ambulances arriving outside have to wait more than an hour to hand over their patient—not in winter, but in every month of the year. Since April, ambulances have lost around 15,000 hours through waiting outside the two hospitals in Shropshire, and one poor patient was stuck in an ambulance in Shrewsbury for 15 and a half hours. As we have discussed many times, that keeps ambulances off the road, and has a knock-on effect on how long people who may be in life-or-death situations have to wait for help. This leads to situations such as the one in my constituency in April this year, where a carer was left alone performing CPR for 23 minutes while being told by the 999 call operator that no ambulance was available. Tragically, the victim died, and the carer who tried so hard to save her has been left traumatised—as, I would imagine, has the 999 call operator. As I mentioned in the Chamber a couple of weeks ago, an 11-year-old in my constituency, Charlotte, has an adrenal deficiency that leads to her needing an urgent injection of hydrocortisone if she has some kind of trauma. When that happens, she is logged as needing an automatic category 1 ambulance response. Recently, a car crash happened involving Charlotte and her mother, and when an ambulance was called for, they were told that none was available, and the family had to make their own way to hospital. That is not good enough. It is endangering lives. The target for a category 1 response time is an average of seven minutes. So far this year in Shropshire, the average has been 11 minutes and 57 seconds. For a category 3 response, which still means that the person urgently needs an ambulance, the average wait is more than two hours, which is more than double the target time. That is not new, but it is very wrong, and it demonstrates the pressure already facing the health service as we head into winter. Perhaps more worryingly, the situation in many areas this summer has been getting worse, rather than better. West Midlands Ambulance Service, which serves my constituency, described a “significant, rapid deterioration of delays at hospital in September which has continued further in October.” The service has been operating with the highest level of risk score for the past year. October is forecast to be the second worst month on record for lost handover hours, with the equivalent of 130 out of 600 ambulance crews in the west midlands being lost to delays every single day—and it is only October. That takes a huge toll on the mental health of the hard-working staff involved at every level. It also undermines staff retention, which will be crucial for any NHS plan, such as the 10-year plan or any winter plan to come. We must retain these experienced professionals; we cannot rely on recruitment alone to solve the staffing crisis in our NHS. These wonderful staff have been stretched to breaking point by years of neglect and mismanagement by the Conservatives. Labour must do better, yet patients and staff are understandably fearful as we approach winter. According to a recent poll commissioned by the Liberal Democrats, one in four people in Britain have avoided calling an ambulance because they were frightened that it would take too long to arrive. Of course, many pensioners are particularly fearful this year. Winter is a perilous time for older people, given the additional diseases that they might catch, and many will be more at risk after being denied the winter fuel payment for the first time. This will be the first winter without the payment being universal, and the annual uprating of the state pension will not make up the shortfall until next spring, which will be too late for people to pay their electricity or gas bill—and if someone in my constituency has to top up their oil tank now, it is too late for that, too. There is a danger, as happened when fuel costs increased two years ago, that people will reduce or turn off their heating entirely, with possible consequences for their health and a knock-on effect on the NHS. So what are the solutions? First, we need to stop throwing money at the fire and instead prepare properly. As we all know, the most cost-effective cure is prevention in the first place. Over the past seven years, the Conservative Government announced an average of £376 million of emergency funding each year to tackle the winter crisis, much of which arrived too late to make any meaningful difference. The Liberal Democrats want to create a winter taskforce armed with a ringfenced fund of £1.5 billion for the next four years. That would be used to build resilience in hospitals, A&E departments, ambulance services and the discharge of patients, and allow integrated care boards and NHS trusts that are struggling to balance their books to plan their budget more effectively in advance to cope with the winter crisis. The taskforce would bring together senior leaders from the NHS and the Government, along with staff representatives, to ensure better co-ordination and preparation for winter. It would be empowered to deliver rapid changes in day-to-day operations to ensure a co-ordinated response—for example, by deploying more beds to certain hospitals or boosting social care capacity where it is most needed. Tackling the issue of patient flow is the most fundamental aspect of steering our health system through this winter and the years ahead. If patients are to be treated on time, they need an ambulance to arrive on time, and that ambulance must be able to hand over its patient to A&E as soon as it gets there. If A&E is to have more capacity, we need to reduce the amount of people there in the first place through prevention and investment in primary care. We must make hospital beds available so that patients can be moved out of the A&E department and into the medical or surgical part of the hospital, as appropriate. If we are to move patients on when they are ready to go home, when they would be better served in their own home with the proper therapy, we must invest in social care and deal with its capacity issue, which is at the heart of so many of these problems. Half a million people in England are waiting for care, stranded in hospital beds that are so important to free up over winter, and those in power have continually ignored social care for many years. I am extremely worried that the Government have not said an awful lot about social care in the Budget today. The additional money announced for local councils, £600 million of which is for social care, will presumably be gobbled up largely by the increase in national insurance contributions and the minimum wage. It is really concerning that those councils will not be able to meet their social care commitments in the future. We urgently need cross-party talks so that, between us, we can commit to a long-term solution to the crisis in social care. Liberal Democrats believe that we should introduce free personal care along the lines of the model in Scotland. That would help people to stay in their own homes and out of hospital and ease the pressure on the NHS. We should pay for a fairer deal for unpaid carers and a higher carers’ minimum wage, which of course, we saw some movement towards in today’s Budget. We welcome that and look forward to the review of the cliff edge in the unpaid carers’ allowance. Critically, a higher carers’ minimum wage must be fully funded, because councils will be pushed over the edge if they are not given the money to support that, as will many small care providers, which provide the vast majority of paid social care in this country. We need to ensure that people can see a GP when they need one, so that they do not end up adding to the overwhelming pressure on A&E departments. I recently spoke to someone in my constituency who waited seven weeks for a telephone consultation. We must ensure that we focus on the outcome for the patient, which is why we would give everyone the right to see a GP within seven days, or within 24 hours if the need was urgent, and we need to increase the GP workforce by at least 8,000 to deliver that. As I said, it is crucial that that is done through retention as well as recruitment and more training. We also need to reform the NHS dental contract and guarantee access to an NHS dentist for anyone needing urgent or emergency dental care, ending the dental deserts that exist in my North Shropshire constituency and the rest of the country. The biggest reason for a child to go into hospital is to have a tooth extracted, because their teeth are in such a poor state. That is scandalous, and I look forward to hearing what the Government will do to address that issue. We also need to support community pharmacists, who are critical to the preparedness of the NHS, by making sure that everyone has access to the healthcare advice and medicines that they need. Pharmacy First is an excellent idea and helps to relieve the pressure on the NHS, but community pharmacists are closing at an alarming rate, and we risk that good idea going to waste. Are enough people being vaccinated against the “tripledemic” of flu, covid and respiratory syncytial virus, including staff? Analysis by the Health Service Journal showed that 283,000 fewer staff received a flu jab last winter than at the end of 2019, despite the number of frontline staff growing. If staff are not protected, fewer patients will be protected when they get seriously ill, and staff will not be able to go to work to treat ill people. Increasing the awareness of what is on offer at pharmacies and reversing the cuts to the public health grant to increase the health and fitness of people up and down the country are both integral to relieving pressure on hospitals and preparing the NHS for winters to come. Stories and statistics from up and down the country show that the NHS was already under extremely severe pressure this summer. That has been the case throughout this year and last year. It is autumn now, so it is critical that the Government outline their plans to deal with the added pressure of the winter to come. More fundamentally, we need bold, long-term action so that winter crises become a thing of the past. We need to train, recruit and retain staff, and make them proud and happy, instead of tired and stressed, with them then leaving the system. We need to fix our crumbling hospitals so that money can be spent on care instead of fighting fires and draining floods. We need to invest in all aspects of primary care, including dentists, doctors, pharmacists and optometrists, as I reminded Members in the Chamber last week. Most crucially, we must confront the crisis in social care. Earlier this week, the Secretary of State said that the Budget will arrest the decline in the NHS, but I am afraid that that is not good enough. The annual winter crisis costs lives, jobs and patient dignity. It also costs the taxpayer more than we can afford. We must invest now; we cannot afford not to do it. We must invest to save so that we have an NHS fit for the future.

• 30 Oct 2024 · NHS Winter Readiness · Hansard source

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  I thank you, Sir Roger, the Minister, the shadow Minister, all my Liberal Democrat colleagues and the hon. Member for Strangford (Jim Shannon) for coming to this debate on a very busy day. I am grateful for all their contributions, which were positive and constructive, as always. I thank the Minister in particular for her comprehensive response. It is reassuring to hear that she has considerable expertise in this area. We welcome the investment that was announced in the Budget, including significant investment in day-to-day NHS spending, capital investment and investment to deal with the repairs backlog, which needs urgent attention. We called for the Government to address the backlog in our general election campaign, because we recognise its importance. However, the very nature of the Budget statement means that we have been a bit light on detail today, and that is why we want to provide constructive opposition and ideas to move this forward. I reiterate my concerns about social care. Little was said about it today, but many social care providers are small businesses that will be heavily impacted not only by the increase in the minimum wage, which is welcome for carers, but by the increase in employer national insurance contributions. We risk a real crisis in those companies and in local government budgets, which are perilously stretched, if we do not have a plan to fund those carers and their wages. I leave the Minister with that thought, and thank everybody for attending. Question put and agreed to. Resolved, That this House has considered NHS readiness for winter 2024-25.

• 30 Oct 2024 · Engagements · Hansard source

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  Q14. The Robert Jones and Agnes Hunt hospital in Oswestry, in my constituency, is home to the veterans’ orthopaedic service, which is by far the largest provider of veterans’ hospital care in the country. It is a fine example of what can be built when the national health service and local authorities work together. It cost no extra public money to set it up but, because of NHS changes in how integrated care boards charge each other, it has been left with a funding shortfall. Will the Prime Minister come to visit this fantastic facility in beautiful North Shropshire to see for himself why it is so important that we keep it going?

• 23 Oct 2024 · Engagements · Hansard source

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  Q11. Shropshire’s farmers have been suffering from flooding following 18 months of incredibly wet weather, topped off last Wednesday by a month’s worth of rain in 24 hours. They were not eligible for the farming recovery fund, and a freedom of information request by Farmers Weekly found that only £2.1 million of that £50 million has been handed out to farmers. Will the Government consider extending the eligibility of that scheme so that we can keep farmers going when they are deluged by floodwater?

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  That is a really important point. A lot of people in my constituency have contacted me for help with drugs—for example, to deal with ADHD. People need to be able to access important medication readily. We must not forget the dentistry element of primary care. A generation of children are at risk of poor oral health because of the mess in which dentistry has been left by the previous Government. Tooth decay is the biggest cause of children being admitted to hospital, with over 100,000 admitted since 2018. That is totally unacceptable. Some 4.4. million children have not been seen by an NHS dentist in the last year, according to the House of Commons Library. Dentistry is really important for children—they have to keep their teeth for the rest of their lives—but this issue affects adults too. My constituent Ron Kelly, who is 62, is disabled and lives in Market Drayton. Members who have been around a while might know that it is not easy to catch a bus to anywhere from Market Drayton. He has not been able to find a dentist since 2019, and my caseworkers have rung every NHS dentist in our constituency. None of them is taking on new patients, so even if he was able to use the bus, he would not be able to find an NHS dentist in North Shropshire at the moment. Office for National Statistics data released last week shows that, in the midlands, 99% of people who do not have an NHS dentist, and who are trying to find an appointment, cannot access one—99%! It is just unbelievable in a modern country in the 21st century.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  I beg to move, That this House regrets that the NHS has been plunged into crisis by years of neglect by the previous Government, leaving far too many people waiting weeks to see a GP or unable to find an NHS dentist, and children and adults waiting months or even years to receive the mental health care they need; believes that everyone should be able to access high-quality primary care services when they need them and where they need them; condemns the previous Government for presiding over a fall in the number of full-time equivalent fully qualified GPs and NHS dentists in the last Parliament; further regrets that the Government has not yet set out a plan to invest in primary care at the level needed to meet demand; calls on the Government to boost access to GPs, NHS dentists and community pharmacists; and further calls on the Government to give everyone the right to see a GP within seven days or within 24 hours if they urgently need to and to guarantee access to an NHS dentist for everyone needing urgent and emergency care. It is a real honour to open this debate on the Liberal Democrats’ first Opposition day for 15 years. Primary care is the front door to the health service, but for too many people at the moment, that door is closed. Whether they are waking up and dealing with the 8 am calling frenzy to get a GP appointment, frantically ringing every dental practice in their area for an NHS dentist, or turning up at their local pharmacy to pick up a prescription for their loved one or themselves and finding it unexpectedly closed or the medicine out of stock, primary care is in terrible trouble and it needs fixing urgently. That is not only to make lives better for the people who are suffering because they cannot access the primary care they need, but to allow the NHS to function more efficiently. Accident and emergency is not a decent substitute door to the NHS. I am an asthmatic and as a young person I had quite serious asthma. I can remember when primary care was absolutely there for me in the middle of the night. On lots of occasions when I needed help, my dad did not have to take me to the hospital in an ambulance. Somebody came to me with a nebuliser and got me sorted out within a couple of hours, and then we all went back to bed. Now, that is not an option for a lot of people. The NHS is in a crisis, and that is causing pain and suffering unnecessarily. The crisis is also costing far more than we can afford. It is costly because early intervention and dealing with people in their community or at their home is so much more efficient than taking somebody to hospital, even if that is in a private car. And it is costly because it causes people genuine pain: the BBC reported that in Oswestry in my constituency this year, a man removed his molar with a pair of pliers because he could not find an NHS dentist. But it is also costly because people are unable to access work, and that is costing the economy. Polling commissioned by the Liberal Democrats showed that one in four people had been unable to go to work while waiting for a primary care appointment. That is not good for an economy that urgently needs to grow. We need urgent investment in primary care—in doctors, dentists and community pharmacists—to save people from having to go to hospital.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  My hon. Friend is entirely right. I believe that the Government are taking steps to address that, but he has made an important point about the need for flexible GP funding. A general practice may have money to spend on professionals and need more fully qualified doctors to deal with its patient list, but can only spend that money on another pharmacist or another nurse. That is a ridiculous situation, and I am pleased that the Government are dealing with it.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  That is an important point. In my constituency, carers who go to pick up prescription medicines are finding that the pharmacists are not there because they are relying on locums. The pharmacy funding problem needs to be addressed as a matter of urgency, and I will say more about that later. Growing the economy is so important that we need to get people off the waiting and referral lists and back into work. Liberal Democrats believe that people should be in control of their own lives, not “chained up” at home, unable to get out of bed, because they have no access to healthcare. They should be able to get the help that they need, when they need it, in their own homes and communities. Let us start with GPs. The Liberal Democrat manifesto—it was well received, which is why there are so many Members sitting behind me on these Benches—called for the right to see a GP within seven days or 24 hours if the situation is urgent, and for those aged over 70 or with a chronic health condition to have access to a named GP. Those rights are extremely important. People who go to the same GP for more than 15 years have a 25% lower chance of dying than those who have seen a new GP in the last year. Primary care networks tell me that their inability to deliver continuity of care because of the shortage of GPs is one of the problems that worry them most.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  I will make some progress now, if that is okay, because I am conscious that lots of people want to get in and make full speeches. We have called for a guarantee for urgent and emergency dental care. Check-ups for those people who are already eligible and those needing check-ups before things such as chemotherapy and surgery were also in our manifesto. It is only going to be possible to offer those guarantees if we deal with the issues in the dental contract and the flexibility of commissioning. Primary care is the front door to the NHS, as I mentioned at the beginning, and Lord Darzi pointed out in his report that that is where we should be investing. At the moment, money is flowing to secondary care—to hospitals—yet most people’s experience of the NHS is with their doctor or dentist. We must ensure that that first point of call is a good point of call, and reduce the numbers of people going to A&E. That is so much more cost-effective, but it is also so much better for those people who could manage their health condition without a crisis and without ever having to go near a hospital. We should also think of the knock-on impacts on those hospitals. We all have horror stories of ambulances queued up outside hospitals because so many people are in A&E and so few people can flow through the hospital. The issues around that are complex, and they link in to social care as well, but the reality is that if we can treat people in the community, we will save the lives of people who need emergency care. This is absolutely fundamental: we need investment in our GPs and in dental and pharmacy contracts because we cannot afford not to do it.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  No, I will make some progress. People do much better if they have access to continuity of care, but 8,000 more GPs are needed to deliver the rights that we laid out in our manifesto. We do not shy away from the fact that that is an ambitious objective, and we accept that it cannot be achieved through training and recruitment alone: we need to retain and incentivise our existing workforce. As I said earlier, seeing people in their communities avoids hospital admissions and saves money. Unfortunately, although the Conservatives promised us 6,000 more GPs in 2019, we ended up with 500 fewer. That is why people are so frustrated. According to the findings of research carried out by the House of Commons Library, GP funding has fallen by £350 million in real terms since 2019. As a result, not only are people struggling to gain access to basic care in their communities, but there is a postcode lottery when it comes to availability of that care. In the area where I live, which is covered by NHS Shropshire, Telford and Wrekin, the number of fully qualified GPs fell from 280 in 2016 to 242 in 2023, despite an increased and increasingly ageing population with a much higher level of demand, while 43% of patients are waiting more than 28 days for non-urgent appointments. The Darzi report showed that the number of people waiting for long periods for appointments is rising throughout the country: it is a national issue. We know that from our own doorstep conversations. Members might ask me, “Where are you going to get 8,000 more GPs from? That is a big number.” Apart from training new ones, we should value greatly our experienced ones. A recruitment and training programme is one idea, and, as my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out, using the dentists we have trained properly is extremely important, but we also need to focus on retention and incentivising our existing GPs, to ensure that we hold on to valuable experience and valuable patient continuity. Let me move on from GPs to local pharmacies. Pharmacy First was a great idea of the previous Government —I am willing to give them credit—but pharmacists are under huge strain. According to the Darzi report, some 1,200 have closed since 2017, and spending under the community contract has fallen. Tomorrow I am going to visit Green End pharmacy in Whitchurch, in my constituency, which wrote to me: “As an independent pharmacy, we’re unable to keep on absorbing costs with losses on dispensing.” The pharmacy is struggling because it is making losses on the drugs that it gives out on prescription. Given that it is a small, independent pharmacy, it does not have a massive shop from which to make profits to subside that work. In 2023, Community Pharmacy England warned of “systemic pharmacy funding cuts of at least 25% in real terms since 2015.” That has led to a postcode lottery of access, and to many pharmacies being unable to have a full-time pharmacist and relying on locums, which has led to a really poor and insecure level of service. That is impacting on people who just need to go and pick up their prescription and get on with their day.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  Other opticians are available, but I did! The Liberal Democrat manifesto suggested solutions to these problems, and they have been well received, as I mentioned before. We have a record number of MPs, and that is because we put this issue front and centre of our election pledge. I urge the Government to reverse the catastrophic state that the NHS has been left in by the Conservatives, to take our ideas on board and to invest in primary care as soon as possible.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  I thank the hon. Gentleman for his intervention. That is an important point and I apologise for not making it in my speech. Optometry is really important, and as somebody who spends their whole life looking for their other glasses, I can absolutely appreciate his point.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  Flexibility of contracting is critical, and learning from best practice elsewhere in the country will help to address the problem. I want to highlight how silly it is that people cannot find an NHS dentist when they need one, because NHS dental funding is actually going unspent. In Shropshire, Telford and Wrekin, the area I know about, £1 million was clawed back in 2022-23 because dentists were unable to spend the money allocated to them; they do not have enough staff to work the contracts with them. I met someone last year who had not had a day off work—we were in October by that point—and he had to hand back his contract. The Government have proposed golden handshakes, but I have heard on the ground that they do not work, certainly in Shropshire. We need a reformed contract, flexible commissioning, a proper statutory requirement for workforce planning, and the ability for dentists to use their funding to manage their own practices in a way that allows them to make a bit of money out of treating patients on the NHS. I also want to highlight the public health grant cuts by the Conservatives and how important it is to reverse them is. It is a complete false economy to cut programmes that help with oral health and prevent poor teeth and future dental problems, when we could spend the money up front so that it would cost far less in the future.

• 15 Oct 2024 · Patient Waiting Times · Hansard source

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  My constituent Mel Lycett has terminal cancer. After repeated visits to her GP, she was referred to a two-week urgent pathway in May. She was not diagnosed until the end of July, and she still has not started treatment. Every single target for her diagnosis and treatment was missed. That is not uncommon in Shropshire, and it is not uncommon in the rest of the country. Can the Secretary of State reassure me of what he is doing to deal with this terrible legacy left behind by the Conservative Government? How will he ensure that cancer patients are treated in a timely manner?

• 15 Oct 2024 · Topical Questions · Hansard source

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  In England, 4.4 million children have not seen a dentist for at least a year. Meanwhile, in Shropshire, Telford and Wrekin integrated health board, £1 million of dental funding went unspent in 2022-23. The system is clearly broken. When can we expect the Secretary of State to fix it?

• 9 Oct 2024 · Engagements · Hansard source

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  Q9. The A483 runs through my constituency from Llanymynech to Oswestry. It is one of the busiest and most dangerous roads in the constituency, and National Highways says the crossroads at Llynclys is the worst accident blackspot in the midlands. It has a proposal to improve the situation, but Treasury rules place a higher value on road speed than on the lives of North Shropshire’s residents. Will the Prime Minister look at flexing those rules to back National Highways and my residents, to give them the safe road they deserve?

• 9 Oct 2024 · Maternity Services: Gloucestershire · Hansard source

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  It is a pleasure to serve with you in the Chair, Sir Christopher. I congratulate my hon. Friend the Member for Cheltenham (Max Wilkinson) on securing this important debate. Maternity services affect every single one of us at least once in our lives, so it is important that we protect them to ensure that, for all of us, that moment—obviously, many of us experience it more than once—is a safe one. I will not mention all the hon. Members who have spoken, but I am pleased to see so many of my Liberal Democrat colleagues, who have all made excellent speeches and powerful points. I particularly thank my hon. Friend the Member for Thornbury and Yate (Claire Young) for sharing her experience, and the hon. Members for Gloucester (Alex McIntyre) and for Stroud (Dr Opher) and my hon. Friend the Member for Tewkesbury (Cameron Thomas) for sharing theirs. Obviously, the hon. Member for Stroud has his own medical expertise, which is very important. Finally, my hon. Friend the Member for Winchester (Dr Chambers) described his constituent’s shocking experience, which I think we were all upset to hear about. This is not the first debate we have had on maternity services—not even the first in this Parliament—and the reason for that is the shocking under-investment in those services. On 19 September, during recess, the Care Quality Commission issued a report, and its contents are hugely disappointing if not surprising. As has been mentioned, it spoke of the risk of normalising avoidable harm, which is an unacceptable situation to be in. Hon. Members might be aware that my interest in maternity care came about because I am from Shropshire—I represent North Shropshire—and my constituents Kayleigh and Colin Griffiths lost their daughter Pippa at Shrewsbury and Telford hospital NHS trust. They fought tooth and nail alongside Rhiannon Davies and her husband Richard Stanton to bring about the Ockenden review into the scandal that unfolded at the trust. Since then we have had a report on East Kent, and there is a review going on in Nottingham. None of that is news to us, which is shocking. I sat on the all-party parliamentary group on birth trauma, which was brilliantly led by the former Member for Stafford, Theo Clarke, and on the baby loss APPG, and I am currently trying to reconstitute the maternity APPG. All those groups have found the same failings over and over again. The CQC report tells us what we already know: 40% of maternity services are rated as requiring improvement and 18% are rated inadequate. That means that less than half are rated as acceptable, which is not excusable, particularly given that we have had so many high-profile scandals and so many commitments—I believe they were made in good faith—from the Dispatch Box that these things will not happen again, but they are happening every single day. We know from all those reports that unsafe staffing is at the root of most of the problems and that it is pushing hard-working midwives, in particular, to the brink. They work their socks off to share in what should be the most joyful moment of each individual’s life. When I had my baby nearly 16 years ago in an emergency situation, the midwife, who had been with me all afternoon, stayed on at the end of her shift to make sure that I and my baby were okay. We received excellent care and were both fine in the end, thank goodness. However, we have all relied so much on the good will of those individuals that they are experiencing burnout at an alarming rate. I was canvassing in my constituency during the general election when a midwife came running across the road in her dressing gown and slippers to tell me that she was emigrating because she had had enough and that two other midwives she knew in the county were taking the same step because they had experienced burnout on such a shocking level. Any workforce plan needs to deal urgently with that problem. Staffing is one problem, but unsuitable buildings are another. In the shocking inquiry into the Lucy Letby case at the Countess of Chester hospital, which is slightly unrelated, I read that sewage was coming up into the hospital’s sinks. How can we control infection when there is literally raw sewage in the building? It is unacceptable. We need to ensure that this Budget invests not just in the GPs, healthcare workers and midwives we so urgently need, but in the fabric of our hospitals. We have repeatedly heard that there is a failure to learn when things go wrong and that hospitals focus too much on protecting their reputation rather than on learning from terrible mistakes that might have happened—and that will inevitably happen on occasion, even with the best staff in the world, because sometimes things go wrong. Hospitals must learn from those mistakes. Finally, there is a failure among hospitals to have an open culture, so staff who have concerns are unable to raise them. The duty of candour law, to which the Government have committed, is so important, and I urge the Minister to ensure that the people to whom workers in hospitals can speak up are independent of the hospital manager and the clinical director. If workers are reporting to the person responsible for giving them their jobs, that is not a safe process. We must have independent whistleblowing procedures for people raising clinical concerns. I am sure my constituents share my anger that we have to return to this topic again and again, when we should be looking at how far we have come since the Ockenden review over two years ago. I want to touch on the point made by my hon. Friend the Member for Carshalton and Wallington (Bobby Dean) about outcomes. Black and Asian women and their babies have a far worse probability of surviving birth than white women. If that was happening in a single trust, we would have another big, important review, but because it is spread out across the country, it is being lost, so we must return to it. It is not acceptable in this country in the 21st century that ethnic or socioeconomic background is a determinant of whether having a baby is safe. We are not on track to meet our 2025 targets for reducing stillbirth and neonatal death, and those targets have not been renewed. I urge the Minister to renew them and to ensure that there is a plan in place to meet them. Finally, my hon. Friend the Member for Winchester made the critical point that spending more on medical negligence than maternity services is totally unacceptable. This country cannot afford for that to continue. We must make maternity services safe, because it is better for the mothers, better for the babies and better for the taxpayer. I look forward to hearing the Minister’s response.

• 7 Oct 2024 · NHS Performance: Darzi Investigation · Hansard source

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  I thank the right hon. Gentleman for his intervention. There is a general problem with care in the community of all types not being there for people. We have people in places where they will not get better as quickly—in some cases, their situation may be deteriorating—because that care is not available. Mental health provision in my constituency is absolutely appalling. People register with a doctor over the border just to access better mental health care. I could not agree with him more. In conclusion, the Darzi report is shocking, but it is not surprising based on the experience of my constituents. Poor access to primary care—whether that is GPs, dentists or early mental health intervention—is leaving people in pain and distress. Long waiting lists and crumbling hospitals are leaving people unable to get back to work, with their situation deteriorating, and the crisis in social care—the elephant in the room—is depriving people of their independence and leaving them in hospital when they could be at home. The new Government must make fixing the NHS and care their No. 1 priority. Liberal Democrats will be here to provide constructive opposition to ensure that they do.

• 7 Oct 2024 · NHS Performance: Darzi Investigation · Hansard source

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  The findings in Lord Darzi’s report are shocking, but Liberal Democrats—there are many of us here today—find that they echo the hundreds of thousands of conversations we had with people on the doorstep across the country throughout the election campaign. In too many ways, the NHS just is not working as it should, and that is a tragedy, because we all cherish the NHS and want it to succeed. It is one of our country’s greatest inventions and a great Liberal idea. It is one of the things that makes us proud to be British. We all owe so much to the NHS and the incredible hard-working staff who have kept it going under the most intense pressure imaginable. Despite their heroic efforts, there is no doubt that we have a major crisis in the NHS. Let us not forget, because it is so important—these things are intrinsically linked—that we also have a major crisis in care. The message that the British people sent at the general election in July was clear: fixing the health and care crisis must be this Government’s No. 1 priority. Before I turn to the Government’s plans, it is worth reminding ourselves of the scale and urgency of the challenge. Far too many people wait weeks to see a GP or NHS dentist, if they can find one. Far too many wait months or even years to start vital treatment for serious conditions. Far too many wait for hours in pain and distress for an ambulance to arrive. I recently spoke to a constituent, Emma, whose 11-year-old daughter Charlotte suffers from a medical condition that means she is red-flagged, or a category 1 priority patient, in the case of a medical emergency. Unfortunately, Emma and Charlotte were recently involved in a car crash. Charlotte urgently needed an ambulance, but after two hours of waiting, her father decided to take her to hospital in the back of his car. She starts her journey to senior school this autumn. Her family have had to devise their own response network to keep her safe and secure, and to allow her to attend school in confidence. Our ambulance service failed Charlotte and her family when they were in crisis, and we cannot let that continue. The problems do not stop there. Across the country, almost 6.5 million people are stuck on hospital waiting lists. That is one in every nine people in England. Two million of them have been waiting for more than six months. Over the past year, more than 100,000 people have waited more than two months to start cancer treatment after an urgent referral. In my constituency of North Shropshire, almost 20% of urgent referrals took more than 43 days and 10% took more than 62 days. The target is 28 days. It is truly heartbreaking. We know that every day counts when patients are battling cancer. Young people needing help with their mental health are waiting months and even years to access child and adolescent mental health services. There is no help for them until they are in crisis. As if all that was not bad enough, we have hospitals that are literally crumbling. There is a maintenance backlog of £11.6 billion. Buildings are decades past their use-by date. It is shocking but, as my Liberal Democrat colleagues and I know, far from exceptional. Most of these problems go back decades. The truth is that Governments of all parties have failed to put enough capital investment into the NHS. They have failed to face up to the challenge of an ageing population and, crucially, they have failed to tackle the care crisis, with one honourable exception: the Care Act 2014 was passed by Liberal Democrat Ministers a decade ago, with cross-party support. Sadly, it was ripped up by the Conservative Government after 2015. The failure and neglect of the Conservative Government left the NHS teetering on the brink. There were so many grand promises—6,000 more GPs, 40 new hospitals and cross-party talks on social care—but they were all fantasies. In Shropshire—which is not an outlier—the Royal College of General Practitioners found that the average GP is seeing 475 more patients than they were in 2016. Patients and their loved ones have been let down so badly. When the scale of challenges across health and social care is so enormous, it would be easy to succumb to pessimism and defeatism—doom and gloom—but we cannot afford to do that. The patients of today and tomorrow cannot afford for us to do that. This moment demands the same urgency, ambition and vision that drove the creation of the NHS all those years ago. We very much hope that the Government will show that ambition. I welcome the Secretary of State’s recognition of the fundamental importance of shifting more focus to primary care—to GPs, dentists, mental health practitioners and community pharmacists—for our young people.

• 7 Oct 2024 · NHS Performance: Darzi Investigation · Hansard source

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  My hon. Friend is exactly right, and we put mental health and access to primary care and health prevention front and centre of our manifesto for that very reason. I encourage the Secretary of State to take our plans where they are complementary to his and run with them. We are happy to have our ideas plagiarised—we will welcome it. Welcome as that focus is, some of what we have heard gives me cause for concern. First, some weeks ago the Prime Minister suggested that investment can come only after reform. I warn the Secretary of State that I do not think that that will work. The reforms that our NHS needs cannot be done on the cheap. Improving access to primary care means investing in more GPs, more NHS dentists and more community pharmacists. Boosting productivity means investing in better IT systems and bringing hospitals up to date with the new facilities they need. I agree that it cannot be just more investment without reforms, but nor can it be just reform without more investment. We need that investment now. The reports that we have heard of potential cuts to spending in the Budget are deeply concerning. I urge the Secretary of State to guarantee today that they will not happen. Finally, I am afraid that there still seems to be nowhere near enough focus or urgency when it comes to care. We simply cannot fix the crisis in the NHS without fixing the crisis in care. Right now, more than 12,000 people in hospital are ready and well enough to go home but stuck there because the care they need is not available. That is awful for them and their families, and it is awful for the NHS that 12,000 beds that should be getting used by patients who need them and allowing better patient flow through hospitals are being held up because the care system is in crisis. I urge the Secretary of State again not to put this off any longer but to set up a cross-party commission now so that we can agree a long-term solution to ensure that people get the care they need, when and where they need it, and that carers are properly supported, too.

• 11 Sept 2024 · Oswestry to Gobowen Railway Line · Hansard source

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  Bearing in mind that local councils are a hair’s breadth away from issuing section 114 notices and are only likely to deliver statutory services in their area, what kind of additional funding will be available from the Government for them to be able to franchise their own bus services? I ask that because it seems to me that it is all very well councils having the power to deliver such services, but unless they have the funding to do so, it will not bring about the results that we would like to see.

• 11 Sept 2024 · Oswestry to Gobowen Railway Line · Hansard source

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  I beg to move, That this House has considered the Oswestry to Gobowen railway line. It is a pleasure to serve with you in the Chair, Ms Vaz. This is an important subject for my constituents in the lovely town of Oswestry and the nearby village of Gobowen. Oswestry has a population of approximately 17,000 people. It is the second largest town in Shropshire and is of huge importance to the border region, but economic potential there is being stunted by poor public transport, which plagues the whole of Shropshire. People who live in Oswestry are forced to rely on a bus or car to get to Gobowen railway station just up the road to access connections to larger economic centres, such as Shrewsbury, Liverpool or Manchester. What about someone who does not have a car and works in Chester? They will need to leave home by 7 am to get to the office for 9 o’clock—a journey that takes about 45 minutes in a car. Someone travelling further afield and returning late would need to get a taxi back from the station because the buses do not run outside regular hours, and that is if they can track down a taxi, which is another problem for another debate. Oswestry was once a proud railway town. The railway station was on the main line of the Cambrian railway and, at one stage, it housed the headquarters of the Cambrian Railways Company. Unfortunately, it was a victim of the Beeching cuts, and there has been no connection to the main line from Oswestry since 1966. That is why the news that the restoring your railway fund would be used to reopen the line between Gobowen and Oswestry was so well received locally; and why the news that the Government wanted to scrap the funding, without even examining the new business case, has been such a huge disappointment. From healthcare and high streets to the environment and the economy, I cannot overstate what a transformational impact reopening the line would have on our area. Poor public transport removes opportunity. It hinders young people, limiting their options for further and higher education and restricting their access to culture and leisure. In short, barriers to mobility are barriers to social mobility. During a recent visit to the jobcentre in Oswestry, the brilliant staff there told me that the No. 1 barrier to people accessing work is poor public transport. Meanwhile, I have spoken to businesses in Oswestry that have reported real difficulties in recruiting. They need to be able to attract people to work from a much wider area than Oswestry and not just those who have access to a private car. That means we are in the ridiculous situation where employers cannot recruit and jobseekers cannot find jobs to match their skills because of the same problem of poor public transport. Let us take the outstanding Robert Jones and Agnes Hunt orthopaedic hospital near Gobowen: it has such a fine reputation that it has no trouble attracting high-quality staff, but the problem is that it cannot get people to and from their shifts early and late because there is no public transport, so if they do not have a car, the job will not work for them. Reopening the line would include a halt at the hospital. That would help to swell staff numbers and ease access for patients, many of whom are elderly, do not have access to a car and have to rely on the good will of friends to get to appointments on time. The hospital is a national resource: people come from across the country to access the excellent care there, including from the veterans’ centre, and railway access for them would be a huge bonus. It is not just me who thinks that this is a great project. Feedback from the Department for Transport on the strategic outline business case acknowledged the importance of all of this: “Oswestry is the second largest employment area in Shropshire, and unemployment in Oswestry is higher than the average in Shropshire. Productivity—the ability to match jobs with labour across North Shropshire—is a particularly pertinent issue. The growth in vacancies has been significant in Oswestry and Gobowen in recent years, which is exacerbated by the low population density and ageing populations of these areas.”