Healthcare in Rural Areas

Gregory Stafford Excerpts

Wednesday 4th March 2026 Westminster Hall

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Dr Huq. I am extraordinarily grateful to my hon. Friend the Member for Mid Bedfordshire (Blake Stephenson), who has campaigned tirelessly for a GP surgery in Wixams in his constituency. I was delighted to hear that his campaigning is beginning to bear fruit, and I wish him well with that.

The challenge that my hon. Friend mentioned resonates strongly in my own constituency. There has been significant housing growth in areas such as Bordon, yet the supporting infrastructure, particularly primary care, has simply not kept pace. Residents move into new homes only to discover that securing a GP appointment is harder than it should be.

Hon. Members across the House have made a consistent and compelling case this afternoon. Rapid housing growth places a real strain on local practices, and patients then struggle to access timely appointments. Infrastructure funding is too often misaligned with development, and co-ordination between local authorities, NHS bodies and developers remains insufficient. Healthcare must arrive with the new homes, not years afterwards.

The Government’s 10-year plan puts having care closer to home at the centre of NHS reform. That ambition is entirely welcome, but as hon. Members have raised, the national neighbourhood health implementation programme begins with pilots in 43 areas, and each designated neighbourhood must serve a population of around 50,000 people. That population threshold presents a fundamental challenge for rural and semi-rural areas, where individual villages and market towns fall well below that figure. Although larger geographical regions might technically meet the requirement, genuinely rural communities cannot qualify as stand-alone neighbourhoods and are therefore excluded from the first phase—and potentially always.

If the 50,000 population threshold is rigidly applied, smaller communities will only ever be served indirectly, folded into large neighbourhoods covering multiple dispersed settlements. That risks diluting the focus on their particular needs, and residents might continue to face long travel times, limited access to primary care and fewer co-ordinated services, as hon. Members have described. That is especially concerning given the demographic trends.

Healthwatch England highlighted in 2023 that the NHS long-term workforce plan projects a 55% increase in the number of people aged over 85 living in rural areas by 2037. Demand is rising most sharply in precisely those areas excluded from the pilot phase. In areas like mine, where hospital access already involves significant travel, the case for strong, well-resourced local primary and community care is self-evident. Excluding rural and semi-rural constituencies from the first wave risks entrenching disparities rather than reducing them.

I also have concerns about cuts and mergers in ICBs. The institutional knowledge and expertise built over many years risk being disrupted during the transition. For example, the Frimley integrated care board, which serves the northern part of my constituency, is being abolished, so the local leadership and co-ordination that previously existed will be lost and responsibilities will be redistributed. Change on such a scale requires clarity of governance, funding and accountability. Without it, delivery will vary and confidence will suffer.

Access to primary care, pharmacy and dentistry remains central to this debate, particularly in rural and underserved communities. Since 2024, more than 200 pharmacies have closed in England. In the first three months of 2025 alone, 31 medium-sized and 24 large pharmacy branches closed. For villages and small towns, the local pharmacy is not a luxury; it is a frontline health service Although schemes such as the pharmacy access scheme and Pharmacy First are supported and welcome, there are significant problems with their roll-out, as highlighted by my hon. Friend the Member for Weald of Kent (Katie Lam), with unions like the BMA trying to undermine that very significant investment.

I have a number of questions for the Minister. For rural and semi-rural constituencies such as mine, the details of the policy matter enormously. First, will the 50,000 population threshold be applied flexibly in rural and semi-rural areas? If so, how will smaller communities be guaranteed equal access to neighbourhood services? Secondly, what is the timetable for expanding the scheme beyond the initial 43 pilot areas? When can constituencies such as mine and that of my hon. Friend the Member for Mid Bedfordshire expect to be included?

Thirdly, how will the continuity of neighbourhood health delivery be safeguarded during the merger and abolition of ICBs, and who will ultimately be held accountable for that if implementation falters? Finally, will the Minister publish clear and measurable criteria for success, particularly in relation to rural access, travel times and coverage of elderly populations so that the House can judge whether care closer to home is being delivered in practice and is not merely a promise?