Long-term Medical Conditions

Clive Efford Excerpts

Thursday 12th June 2025 Westminster Hall

[Several hon. Members rose—]

[Clive Efford (in the Chair)]

I remind Members that they must bob if they want to take part in the debate.

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[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) on securing this important debate. I declare an interest as an NHS consultant paediatrician. In my clinical work, I have seen at first hand the impact that chronic conditions can have not just on the health of individuals but on their families, their carers and their wider communities. These are conditions that can shape daily life in profound and enduring ways.

In some respects, the increased prevalence of long-term conditions is a success story for the medical fraternity, because some conditions that previously would have led to a patient’s death can now be managed effectively for a longer period of time, and people can continue to live happy, healthy and fulfilling lives. There is no silver bullet for tackling such conditions, but effective interventions and systems can improve quality of life, enable independence —we have heard about the importance of that—and reduce avoidable healthcare costs. Such interventions require a co-ordinated, whole-system approach, bringing together local authorities, NHS trusts, public health, education, social care and the voluntary sector.

I am glad that the Government are talking about a move away from reactive and acute-based care towards prevention, rehabilitation and supported self-management in the long term. I note that the hon. Member talked about care on Teesside some years ago. As someone who grew up on Teesside, I remember the Carter Bequest hospital—I do not know whether his father had anything to do with that—which was the local community hospital providing community care for many local residents.

We increasingly see patients living with not just one long-term illness but multiple long-term illnesses, known as multi-morbidity. That provides challenges, because sometimes the medication that one would ideally provide a patient for condition A is complicated because they also have condition B, for which they are taking something else that would interact with that medication. A patient might also need an operation but not be able to have it because another condition makes the anaesthetic risk too high, so the management of the second condition might have to be suboptimal as a result of the first condition. Some people have more than two conditions.

One of the challenges that people with long-term conditions will face is staffing and workforce. I notice that the Government have decided to cancel, or at least significantly reduce the availability of, level 7 apprenticeships, which train our specialist nurses in advanced clinical practice, our district nurses and our community nurses. Will the Minister talk to her colleagues in the Department for Education about how there can be a move towards community care and prevention if they are going to make it more difficult to train the people who would provide that care?

The hon. Member for Eastbourne (Josh Babarinde) talked about the delay in follow-up appointments. I have seen that myself. One of the challenges is that when one is under pressure to meet the 18-week pathway and there is no similar pressure on follow-up appointment timings, the consultant’s clinic inevitably ends up with more new patients and fewer follow-ups. The follow-ups get pushed back, often for many months. How will the Minister’s team ensure that the pressure to meet the 18-week pathway does not cause chronic illness to be covered less well than it is now?

I was also interested in what the hon. Member for Newport West and Islwyn (Ruth Jones) had to say about exercise and lifestyle. I see a lot of children with varying conditions in my clinics as a paediatrician, and I have been amazed by how fresh air and exercise, diet and hydration, sleep, and not spending hours on computers, particularly in the evening and through the night, can make a whole range of medical conditions better. We know that the same is true of adult care in some cases. While it is not the cure for all conditions—of course it is not—in some cases it can help people to live better with the conditions that they have. I am interested that in some cases people are allowed only a few physio appointments before they get referred back to their GP. Perhaps longer courses of physio treatment could help people a little more.

Multimorbidity was recognised as a priority in the previous Government’s health and care White Paper in 2022. Community diagnostic centres opened in order to play a vital role in providing quicker access to essential tests, dealing with the backlog left by the covid pandemic. There are two centres near my constituency, in Grantham and Lincoln. I visited the one in Lincoln recently, which has had very good feedback from constituents and is providing a great service. Can the Minister confirm that community diagnostic centres will continue to be well funded following the spending review?

The previous Government launched a major conditions strategy in 2023, aiming to address six key areas—cancer, heart disease, musculoskeletal disorders, mental ill health, dementia and respiratory disease—but the current Government have paused work on this strategy. They came to power saying that they had a plan. They stopped the plan that we had, because they wanted to think of their own, which is fair enough. But we are now three weeks out from the first anniversary of their election, and still this magic plan has not appeared. I say to the Minister that this is too long to wait for people who are unwell. Can she, at the very least, commit that the 10-year plan will be published before we have lost one year in which the Government could have started delivering it?

Musculoskeletal conditions are particularly common long-term conditions, affecting around 20 million people in the UK—that is a third of women and about 30% of men. They are the second most common cause of economic inactivity after mental health, and take a considerable toll. I thank advocacy organisations such as Versus Arthritis for their tireless campaigning on this issue. They have highlighted how these conditions disproportionately affect women and those living in deprived communities.

The recent cuts to the personal independence payments proposed by the Government have disproportionately affected people with MSK conditions. Have the Government conducted an impact assessment? My concern with the PIP changes is that they were announced to meet an economic target, rather than being properly thought through. Can the Minister confirm whether they have been properly thought through? Has an impact assessment been conducted, and if so, will she ensure that it is published so that we can all study it in some detail?

Mental health should be treated as a core component of long-term care. People with long-term conditions are two to three times more likely to experience mental ill health. Research shows that people who are confident in managing their long-term conditions have not just fewer A&E visits and hospital admissions but better mental health. What concrete steps are the Government taking to improve mental health provisions specifically for those with long-term conditions?

Rehabilitation can be just as important to health outcomes as medicine and surgery. As was mentioned earlier in the context of strokes, some people have very good stroke rehab care, but for others that is less of the case. Rehabilitation, particularly early rehabilitation, is very important. Providing timely rehab and self-management advice would significantly reduce the number of people diagnosed with health conditions in their 40s and 50s, for example, being pushed out of the workforce, which drives both income and health inequality.

Is improved access to community rehabilitation for people with long-term conditions part of the Government’s plan to shift from hospital to community care, keeping people out of hospital and in work for longer? I know that the plan is not published yet, but perhaps the Minister knows. Long-term conditions will define the health and social care agenda of the next decade. That requires a joined-up strategy across healthcare, the Department of Work and Pensions, and social care, and for the Government to support the most vulnerable and maximise the quality of life for all our constituents who suffer from long-term conditions.

[Clive Efford (in the Chair)]

I call the Minister.

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[Peter Prinsley]

I thank all who have contributed to this interesting discussion. I particularly thank my hon. Friend the Member for Wellingborough and Rushden (Gen Kitchen), who has acquitted herself extraordinarily well and should be congratulated. It is quite obvious that many of our fellow citizens are depending on us. It is also obvious to me that the politics of healthcare really do matter. We have an opportunity to do something about this, and we must seize that opportunity, because I believe that is one of our great missions. I thank everyone very much for coming to the debate this afternoon.

[Clive Efford (in the Chair)]

My congratulations to the hon. Member for Wellingborough and Rushden for filling in ably for the Minister.

Question put and agreed to.

Resolved,

That this House has considered long-term conditions.