Long-term Medical Conditions

Peter Prinsley Excerpts

Thursday 12th June 2025 Westminster Hall

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Efford. Long-term conditions need a long-term plan. We were promised one of those, and it cannot come soon enough. The Chancellor’s statement yesterday, which committed to a 3% real-terms rise in NHS funding each year, gives me enormous hope for the future of our health service. Some 70% of that funding will likely go to the treatment of long-term conditions, so it is incredibly important that we consider how we should treat them.

Most of us at some point will collect a few long-term conditions. Some of us are born with them; sometimes, they are serious disabilities. I am sure that we will hear some stories of those challenges. I reached out to the people of Bury St Edmunds and Stowmarket and heard many stories about their experiences of using our NHS. All too often, it is the same story: it is those with long-term conditions, not deadly diseases, who feel most let down now. The reality for many is that by the time they reach my age, they are fortunate if they have never had to visit a clinic or see a nurse about something that is no longer working quite as well as it should. The wheels begin to fall off all of us eventually.

Living with a long-term condition has a profound impact on people. It can mean lost work days, missed opportunities and, for many, being pushed out of the workforce altogether. When people are unable to work because of poor health, they are cut off from society and their quality of life obviously declines. That also has a terrible effect on the economy. It is estimated that successfully addressing the crisis in long-term sickness would increase GDP by between £109 billion and £177 billion over the next five years, generating billions of pounds of additional tax revenue. This is a growing trend and as the population gets older it will simply become more pressing. I worry that we have not truly adapted our medical system to deal with this reality.

When I was a medical student, a heart attack was managed with morphine and bed rest. Things have certainly changed, and yet the NHS has not changed enough. In 1948, it was created to deal with infectious diseases and acute hospital care, but the health needs of the population have changed completely. People now live long lives with conditions such as heart disease, diabetes and arthritis. We need to focus on keeping those people in the community rather than waiting until they become so unwell that they have to be brought to hospitals.

The NHS should not just be a sickness service; it should help people to manage their conditions and live much better lives. During our debate on dementia a few days ago, I heard many moving stories about families challenged by that devastating illness. Dementia fills so many hospital beds, and the cost to society is quite staggering, but the real message of the debate was about the need for better community care and greater investment in technology and research. That is true for dementia, but it is also true for many long-term conditions. We have the time and the ideas; now, we must use them.

There is much talk about moving care from hospitals to the community, which is not a slogan but an absolute necessity. I have seen it work in practice: before I came here, I was involved in a project that moved care for people with hearing loss out of hospitals and into the community. Patients benefited from easier and quicker access to specialist NHS audiology and nursing services. We now need to see such an approach rolled out across the country.

The neighbourhood practice model advocated by my Suffolk GP colleagues must be part of the answer, with community health hubs open into the evening, resourced with nurses and mental health services and incorporating a pharmacy, with a GP who is known to the patient and to the family. Those hubs would be the place to call when sick—a better option than calling 111 or having a long wait in A&E. They would offer access to multi-disciplinary teams all in one place, a bit like the geriatric day hospitals that my dad, Professor Derek Prinsley, a pioneer of geriatric medicine, introduced into his practice in Teesside in the 1960s.

The NHS must be a neighbourhood health service, not just a national health service. That is how we join up care so that patients no longer feel like they are being pushed from pillar to post. Instead of being rushed between different appointments in hospital corridors, people should be cared for in one place, bringing lifesaving continuity of care. It is time to end the fragmented system of the past, where people ended up in A&E simply because there was nowhere else to go, and where we had older people lying in trolleys in the early hours for long-term conditions that could have been managed in primary care. A&E should be for real accidents and emergencies. That is how we must start thinking about the long-term care of long-term conditions.

At the centre of our thoughts must be the patient. Health services are all too often designed to deal with patients with a single disease, but for a growing number, that is no longer a suitable model. If I have high blood pressure and asthma, I have to visit the practice three times: once for the blood pressure check and once for the asthma check, and then another appointment to see the GP. I think we can do better than that.

How can we truly put the patient at the centre of healthcare? As I have said before, one answer is to embrace the digital transition and change the medical record paradigm. Let the patient have the record. Give them agency over their healthcare. If people knew a bit more about their health, they might care for it a bit better. More than one in five patients with a long-term condition has said they do not have enough information to manage their condition. That is 5.5 million people across the country who are not confident that they can manage their condition, so let us have the doctor ask the patient for the record, not the other way round. That would be a revolutionary change.

I would like to talk about medical research. Of course, our country has an incredible record of medical research: Jenner, who devised vaccination; Lister, who invented antisepsis; and Fleming, who discovered penicillin—British doctors who saved unimaginable numbers of lives. Then there is Dr John Snow, who removed the handle from the water pump in Broad Street, near to where we are sitting today, ending the cholera epidemic and founding the field of public health. It is on scientific advances like those that we mostly depend as we fight many long-term conditions. We will hear of artificial pancreas pumps to treat diabetes and genetic treatments to cure sickle cell disease and arthritis, but let us not take that progress for granted. We should support medical innovation and put the best technology into the hands of our doctors.

I am proud that the Government are boosting investment in diagnostic machines in hospitals across the country, because I have been told by constituents about the struggle of misdiagnosis—months and years spent unsure what is wrong with them, with doctors unable to shed any light. We are rolling out artificial intelligence and improving diagnostics across the country, and the Government have promised to support that further.

Improving researchers’ access to medical data will be part of the approach. Let us imagine the scientific advances we could make if researchers could conduct studies on sample sizes of 67 million people. Scientific and medical advances depend on our brilliant young people, who must be funded and supported as they embark on research careers. The number of clinical academics is in decline, which is a particular worry of mine. We should challenge that and reverse it. The NHS is easily the biggest employer in our country—perhaps one of the biggest employers in the whole world—but what are we doing to ensure that its people can best support us?

A failure to tackle long-term conditions is significantly impacting the NHS’s own workforce. Musculoskeletal conditions, rheumatoid arthritis and osteoarthritis are leading causes of absenteeism among NHS staff, with ambulance and clinical support staff particularly affected, but we also hear many examples of terrible workforce planning. We learn of nurses and midwives graduating from colleges carrying large debts, after working for thousands of hours on placements for free, only to find a recruitment freeze in the very hospitals that desperately need their skills. Instead, hospitals are spending huge sums on agency staff. This is not a long-term plan; this is short-term thinking of the very worst kind.

I am glad that agency spending fell last year. We must make sure that we spend wisely on newly qualified nurses and midwives, which will end up saving the NHS enormous sums. We also ought to do something about their student debt. Why not write it off if they commit to working for five years in our NHS, giving them security? Our health service needs their expertise.

What about the young doctors, of whom I have spoken before? We need enough GPs, nurses and clinicians to help people to get well, but every year, thousands of UK doctors qualify with debts of up to £100,000. Many are then sent far from home, family and friends just as they begin their careers, and after two years they face intense competition for higher training against thousands of international doctors who fill up our hospital rotas and keep our services running. Some young doctors find themselves repeating their foundation years or going overseas, and others leave medicine altogether. This is certainly not a long-term plan.

We must do better. I have seen for myself that our hospitals can run better with the resources they already have. At my West Suffolk hospital I saw the results: corridor care has been abolished and long-term waits in A&E are now a thing of the past. That has been done by taking a whole-hospital approach to improve the patient experience and ensure that the appropriate health professional is dealing with the patient at the earliest opportunity. That does not cost more, the staff are happier and the service is massively better. That is what happens when we put people first, work together across the disciplines and take real responsibility for change.

Mr Blair once spoke of dealing with crime and the causes of crime; today I speak of dealing with diseases and the causes of diseases. Poverty, poor nutrition and poor housing are at the heart of so much of our country’s ill health. Those are not just background factors; they are the root cause of suffering and long-term conditions. If we are truly committed to a healthier society, those are the challenges we must address.

The mission of our party and our Government is to lift millions out of poverty, tackle deep inequality and shape people’s health from cradle to grave. We will not accept the shocking housing conditions endured by so many of our fellow citizens. These are not simply political and economic problems; they are the underlying causes of much disease and misery, and many avoidable deaths.

There is much for us to do, but I am convinced there is much that we can do to create easier access to NHS services, improve primary care and support those who want to conduct groundbreaking medical research. I hope the Government will look to tackle our long-term conditions crisis.

[Several hon. Members rose—]

--- Later in debate ---

[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.