Coastal Communities (Health) Bill

Pam Cox Excerpts

Friday 13th November 2026 Commons Chamber

[Steff Aquarone]

That surely defies all sense. I understand, as my hon. Friend alluded to, that for reasons of professional development and training it may not be possible to deliver all services in all areas, but acute and emergency care is surely beyond reproach. I am yet to hear any understanding or potential safeguards for that risk from the Government, either here or in the other place. There was no acknowledgment of it when I brought forward and spoke to an amendment on the Health Bill, or when Lord Patel did so in the other place. Coastal communities deserve an explanation of why the Government are not ensuring that health services are delivered for them.

[Pam Cox (Colchester) (Lab)]

The east of England has one of the longest coastlines of any region, so we too are familiar with the challenges faced by coastal communities. The University of Essex has an exemplary centre for coastal communities, led by Dr Emily Murray, an epidemiologist and public health expert. Will the hon. Gentleman join me in commending the work of that centre and in encouraging Ministers to meet representatives from the centre to hear their recommendations?

[Steff Aquarone]

I surely would, on condition that the hon. Lady allows me to join them, because I would really like to hear more about that work. I am sure it would have a great impact on my part of the east of England, which is quite a big part of the United Kingdom.

When I have tried to question the Government on the specifics of their work, I have not received anything substantive. In July, I asked how many meetings the Minister for health disparities had attended in relation to coastal health inequalities this year, and I was told:

“Ministers in the Department meet regularly on a range of topics, including tackling health inequalities, to which coastal inequalities are closely linked.”

I asked which meetings had taken place; I received a general assurance. I asked what specific work was being done, and I was referred back to that general assurance. Ministers must be able to tell Parliament what they are doing, who is responsible and what has changed. It is becoming a worrying theme that coastal health inequality is being kicked out to sea, so I hope the Minister can provide some straight answers on what the Government have done and will do to make a difference.

People in coastal communities want the reassurance that this House, which has more than 100 MPs who represent coastal communities, is placing a legal duty on Ministers responsible for tackling the issues that matter to them. This lack of action or record of delivery is growing more and more worrying.

The other part of my Bill relates to a cross-governmental coastal health strategy. It is rare for politicians to admit when an idea is not theirs, but I will admit that this is not my idea. In fact, it is not even very new. It was a core recommendation of the Chris Whitty report in 2021.

I am sure that the Government will be keen to point out their existing health plans and strategies. While those do important work in places, they will not do enough to recognise the specific challenges of delivering coastal healthcare. Coastal communities suffer from the challenge of the half-compass effect when seeking access to healthcare. It might sound obvious, but when residents in Mundesley or Cley seek to access healthcare, half the compass directions they could travel in would take them straight into the North sea. To my knowledge we are not yet building GP surgeries or dentists there. Yet we still risk planning services as though patients can travel in every direction.

This morning I received a letter from a constituent in Holt, who had been referred by his GP for an MRI scan but was told there was only availability at the Norfolk and Norwich hospital, some 25 miles away. It is a six-hour round trip on public transport. He cannot afford a taxi and there is no hospital transport available, so he has declined the test. He asked me, rightly, how many other constituents find themselves in this situation because of inadequate access to healthcare on the coast.

Geography has to shape provision. If we take a one-size-fits-all approach to healthcare delivery, it will only be half as effective for coastal communities. A strategy that pulls together all parts of government that have an impact on and interest in tackling coastal health inequality is important to bring together the action necessary to face up to this challenge.

This speaks to the core of my vision for a country that works for people, to rewire Westminster around the lives that people lead. A patient misses an appointment because there is no bus. Their health deteriorates because their home is damp. They cannot get the help that they need because the local service cannot recruit. Westminster files those problems under different Departments, but that person experiences one life. We should organise government around that life. We should give people responsibility for the outcome, the resources to deliver it and the funding and authority to work meaningfully across Departments, not just within annual budgets.

Tackling coastal health inequality is a great opportunity to show that this can work. This Bill does not list exhaustively all the things that the strategy should do, but it does touch on many of the key issues that Professor Whitty identified and that I and my constituents see and live with every day.

The strategy would look at the recruitment and retention challenges of coastal communities, which come from being at the end of the line and lead to an extreme workload for those who do healthcare work in our areas. The chief medical officer’s report outlined how there are 14.6% fewer postgraduate medical trainees, 15% fewer consultants and 7.4% fewer nurses per patient in coastal communities. I have seen this at first hand in my area when it comes to securing enough trained pharmacists to keep community pharmacies open and operating in our coastal towns. Many will remember the scandal of the failure of Jhoots. It was noticeable how many coastal towns were impacted by that collapse. The localised factors of transport, environment, employment and more would also be addressed in this strategy.

When seeking to address health inequalities, the Government need to truly understand how being coastal affects Cromer and Sheringham differently from Whitby or Grimsby. There are different characteristics of the coast—fishing, ports, tourism, rurality—and all need their solutions to be well tailored.

To that end, I strongly encourage them to take a look at the excellent work of the Coastal Navigators’ Network, which has been taking on this great challenge and building a nationwide network of local government and health professionals to find solutions to challenges faced by coastal communities through the lens of opportunity. They understand how that investment, and the time and energy that is spent getting to the root causes of much of coastal inequality and deprivation, can pay excellent dividends in both wellbeing and economic terms.

The test of the strategy will be what changes—how staff are recruited and retrained, how patients reach appointments, and how investment prevents ill health. Each commitment needs an owner, a timetable, and a measure of success. We cannot have this becoming another nice document that becomes confirmed to a fate similar to that of the “display department” in Douglas Adams’s “Hitchhikers Guide to the Galaxy,” meaning that we might find the coastal health strategy

“in the bottom of a locked cabinet, stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard’.”

Publishing a strategy is not the same as delivering it, and Ministers should return to the House and tell us what has improved, what has failed, and what they will change.

When Chris Whitty was on our television screens every night, giving us evidence and making recommendations backed by data and in the public interest, the Government listened to him and trusted him. We listened to him and trusted him. There has been no change in his methods when assessing the challenges of coastal communities. His reasoning and recommendations are just as well thought out as during the pandemic. Coastal health inequality is another challenge of our times, and the data show that we are losing the battle. We cannot allow this approach of sidelining coastal issues, or assuming that they could be picked up by another non-specific piece of work as an afterthought. The coast is where the country begins for millions of people. It must not be where the Government’s ambition ends. Give this Bill its Second Reading, and make improving healthcare a responsibility that Ministers must answer for.

--- Later in debate ---

[Sadik Al-Hassan (North Somerset) (Lab)]

In my constituency, our coastal towns of Clevedon and Portishead are places of real character, with Clevedon’s grade I listed pier, Portishead’s maritime and dock heritage, and communities with a fierce sense of pride and belonging. As many Members of the House know, before I was elected I worked as a community pharmacist for nearly 20 years across the south-west. Behind the pharmacy counter I saw the health inequalities between coastal and inland communities first hand. The Chief Medical Officer’s report exemplifies that disparity.

Five years ago, Chris Whitty warned that if health problems in coastal communities were not tackled vigorously and systematically, we would face

“a long tail of preventable ill health.”

It is a problem that will only get worse as populations age. That warning matters in North Somerset. Today, 11% of our population is over 75, but by 2043 that will rise to 14%. The 2021 census showed that people in coastal areas are more likely to report bad or very bad health. In Clevedon, 6.7% of people said that their day-to-day activities were limited a lot by their health, and the figure was 5.2% in Portishead.

As the hon. Member for North Norfolk (Steff Aquarone) mentioned, coastal communities are harder to recruit in when it comes to health. My first-hand experience of trying to recruit pharmacists and health care professionals, such as pharmacy technicians and dispensers, across coastal communities in the south-west has shown me that it is problematic in those areas to get the healthcare professionals we need. That is also true of GP surgeries. The south-west has the highest community pharmacy vacancy rate at 14%, and workforce planning needs to reflect the ageing population in coastal communities, which will fuel the demand for healthcare.

I hate to agree with the hon. Member one more time, but I believe the Government need to have a Minister specifically responsible for coastal communities, to push a cross-Government and cross-Department strategy to try to bring those inequalities in coastal communities closer to those of their inland neighbours.

Transport and access to health hubs in coastal communities are more difficult, and that can be problematic not just for attending a GP appointment or getting to a pharmacy, but for getting to work for those working in a healthcare establishment. Pharmacy tends to map towards deprivation and health inequalities in this country, with higher numbers of pharmacies located where inequalities are greatest, and that links to coastal communities and rural areas. When pharmacy is impacted by funding cuts and closures, that tends to hit those communities worse, such as with the closure of the Jhoots pharmacies in Portishead. We lost two of the three pharmacies in that area, meaning that one pharmacy was left to serve a population of around 25,000. Thankfully, with the help of Magna Pharmacy, we have managed to reopen those two pharmacies, but closures make coastal communities particularly vulnerable due to the health inequalities.

[Pam Cox]

I have put on the record my support for particular initiatives around coastal communities. Clause 4 of the Health Bill gives the Secretary of State a duty to have regard to reduce inequalities in access to health services for people in England. Does my hon. Friend agree that Ministers should be mindful of the needs of coastal communities when looking at that clause?

[Sadik Al-Hassan]

I agree with my hon. Friend’s wise intervention. As I have said, I would go further and put in place a Minister with a responsibility for coastal communities, so great are the health inequalities. They require such a focus.

The 2021 report by Chris Whitty made several recommendations, and I urge the Government to take them forward. We need a cross-Government strategy for coastal health. We must ensure there are sufficient healthcare staff in coastal areas as recruitment levels are often lower than the national average, which, as I say, I have personal experience of.

Finally, we must undertake better research. Coastal communities have been chronically understudied in public health research, and that gap leads to worse inequalities. An ageing population adds to pressures on local services, from getting appointments at GP surgeries to access to Pharmacy First at community pharmacies.

I welcome the hon. Member for North Norfolk raising this issue. Someone’s postcode should never dictate their health outcomes, and I will continue to champion the health of North Somerset’s coastal communities today and for the years ahead.