NHS Funding: South-west

Noah Law Excerpts

Wednesday 11th June 2025 Westminster Hall

[Steve Darling]

That is very insightful. After being around medics for many years, I know the concern about the increase in managers. Equally, I know that integrated care boards, which I will come on to now, have real challenges with the savings that they are making. There is talk of merging ICBs, including, in the far south-west, a merger in Cornwall and Devon. Both ICBs are relatively challenged, and I fear that it could be a marriage of two bankrupts. Perhaps it would be better to look at a bigger footprint, including Somerset.

[Noah Law (St Austell and Newquay) (Lab)]

I welcome and echo the hon. Member’s comment about an inappropriate marriage in respect of the Devon and Cornwall ICBs. They have quite different issues. I commend the work of Cornwall’s ICB, of course, but we have to recognise the specificities of the peninsula penalty and the unique challenges facing both our areas.

[Steve Darling]

That is also very insightful. There are lots of good staff throughout the NHS, including in ICBs. It is about unlocking their potential, which I hope the Minister can do.

I was suggesting a bigger footprint, which could include Somerset and maybe even Dorset, as well as Devon and Cornwall, to give greater corporate capacity. I hope the Minister will reflect on that. Perhaps she will give some guidance on when we will hear about the ICB merger. A larger ICB could reflect the footprint of a mayoral authority; I fear that we could be poorer country cousins if we have only two county mayors in the west of England.

The real challenge with our ICB is that we are looking at a quarter of a billion pounds in cuts to services for Devon. The Exeter trust faces £69 million in cuts. The way to save money is mostly by not filling posts, so that is a real challenge. In Torbay, the figure is £42 million. We have an integrated care organisation, as a result of the merger of NHS acute and social care services, and people often say that is the direction in which we should be going. It saves 60 beds in the hospital by ensuring that we get people out of hospital sooner and into their own homes, where they want to be. However, I worry that the organisation is threatened by the quarter of a billion pounds-worth of cuts to services in Devon coming down the line; I fear for its future. I know that the Government actually want to move in the direction of services working together—it is so important.

The last area I want to touch on is Getting It Right First Time. I have heard from a number of professional sources that they feel that is a metropolitan approach that does not always work well in areas with significant rurality, such as Devon, mostly because it does not take into account some of the deprivation we have, our coastal communities, rural communities and the need for travel, or the fact that our population is older than those in metropolitan areas. We have older folk who are perhaps more digitally excluded. The approach does not always work.

We have seen that in respect of a procedure called PPCI—I will not share what that stands for, but it is an intervention used when someone is having a heart attack. They have a balloon inserted through their groin that goes up to the artery, and a stent is inserted to prevent a blockage in the system. A proposed merger in the offer will see people from south Devon drive past Torbay hospital and go 24 miles up the road to Exeter. That was originally the out-of-hours service, but it is now the emergency service, so when someone is thrown in the back of an ambulance, assessed and told, “You need this intervention,” they will go up to Exeter.

As my son says to me, “Time is tissue.” A consultant told me that if we push forward with this approach, it could result in greater debilitation and deaths. As a result of campaigning, the can has been kicked down the road on two occasions, and the ICB is due to return to the issue again at the end of July. I thank the medics who stood up and shared their concerns about the issue, as well as the thousands of people who signed our petitions on it. This situation shows how, because of the challenges in more rural areas, Getting It Right First Time does not always lead to the right solutions.

I would welcome the Minister’s reflections on wave 2 mitigation, on the challenges in relation to ICBs and, finally, on coronary care issues in south Devon and how we can ensure that we are providing an appropriate service for our communities.