Hospice Services: South Devon

Richard Foord Excerpts

Wednesday 29th November 2023 Westminster Hall

[Kevin Foster]

I must say that that is slightly far away from south Devon, but the hon. Member for Strangford (Jim Shannon) always manages to find a relevant point in his interventions. The nub of his point is rightly received, although he will, of course, recognise that there is devolution of healthcare responsibilities to Northern Ireland, which makes that slightly different from the responsibilities of the Minister who is here today.

Like other public services, businesses and community organisations, hospices have faced increase costs. For example, Rowcroft Hospice outlined to me that the cost pressures that they face include a 30% increase in total staff costs and a 52% increase in utilities bills, and yet NHS funding—what they receive for contracts—has only increased by 8% in five years.

Alongside these pressures, demand is growing. We should never talk about what I am about to say as if it were a problem: more people are living longer, in good health, well into their 70s, 80s and even 90s. That is the biggest and most positive achievement of modern science, healthcare and public health measures implemented since 1948. It is not a problem, which is how we sometimes talk about it. Many conditions that once cut lives short can now be cured or no longer circulate, yet there remain conditions that are likely to affect us later in life that will require palliative care. According to major study published by BMC Medicine in 2017, if age and sex-specific proportions relating to palliative care remain the same as in 2014, the number of people requiring palliative care will grow by 25% from just over 375,000 to just over 469,000 by 2040, but if the upward trend observed between 2006 and 2014 continues, it will increase by 41.2%, with the biggest drivers being conditions such as dementia and cancer. In south Devon, those estimates would see the demands on Rowcroft Hospice grow from 2,500 patients per year now to over 3,500 by 2040. The pressures outlined above apply not only to those working with adults, but also to children’s hospices where funding from local integrated care boards can be patchy—it actually fell on average between 2021-22 and 2022-23.

I note that the Department for Health and Social Care and NHS England have provided vital centrally distributed ring-fenced grants to children’s hospices since 2007. As the Minister will be aware, NHS England initially indicated to hospices that 2023-24 would be the final year of that grant, but I am pleased to note that, after a campaign by the group Together for Short Lives, it has been confirmed that NHS England will be renewing £25 million of funding for children’s hospices in 2024-25. That is excellent news, but I note that it has not yet been confirmed how children’s hospices will receive that funding or how much each of them will receive. I am sure the Minister does not need reminding of the potential impact on vital services if such funding is not available in future. Initial indications from hospices are that they will see a range of services reduced.

It is easy to outline problems in any debate, but there are also great opportunities to provide solutions, the greatest of which could help transform our view of the role of hospice care in south Devon. The Ella’s Gardens project is a transformative vision of what high-quality palliative, nursing and residential care should look like in the middle of this century. At its centre is the construction of a new in-patient unit and the remodelling of the existing hospice building to provide the very best specialist palliative care for generations to come. The proposal is to enhance hospice care for patients and their families by increasing the number of single beds from the current two to 14 to further support the local population and help to meet future demand for specialist palliative care, giving hospice patients and their families even greater independence and choice during those vital moments together. It also aims to enhance the level of care to ensure that patients’ physical, emotional, social, psychological and spiritual needs are being met, while enabling family and friends to stay overnight to be near loved ones.

Rowcroft’s vision is also to build greater financial resilience by reducing the reliance on current income streams such as retail and fundraising. A core part of that is the creation of a 60-bed, purpose-built specialist dementia and complex care nursing home, designed on the leading model of dementia care—I hope I pronounce this correctly—called the Hogeweyk, with six households of 10 residents. Alongside that is a 40-bed assisted living complex, with a proposal that would enable Rowcroft to meet the wider care needs of the local community, as well as providing an invaluable income stream to support the hospice’s ambitions.

[Richard Foord (Tiverton and Honiton) (LD)]

I am grateful to the hon. Member for securing the debate. I wish him condolences for his mother and stepdaughter. He talks about physical space. Seaton Hospice at Home currently works out of the Seaton and District Hospital League of Friends, and relies on that physical space. I know that at Rowcroft, four out of five patients are treated at home. Does he agree with me that palliative care nurses, after working with patients, need somewhere to come back together and operate as a team?

[Kevin Foster]

The hon. Gentleman makes an important point in highlighting hospice at home. The service is growing because many people do not want to be in a hospice or a hospital, and if given the choice, they would rather pass away at home surrounded by their loved ones. My stepdaughter was supported to do that. It is quite an experience when it happens, but it was what she wanted.

The hon. Gentleman is right to say that there is a need for those groups to have the type of facilities they require and be supported in that. I accept that, given the sheer area that some hospices cover for that service, they may have to have some form of remote working arrangement for most of the day, but certainly, I see how Rowcroft provides that facility and it works well. There is that balance of the hospice for those who need it and are at that stage in their treatment and care, and the hospice at home to try to give people the choice they deserve at the end of their lives.

The plans have been developed in a way that allows residents to live in a caring, nurturing and vibrant home that supports as much independence, mobility and inclusion as possible. The Ella’s Gardens vision is not just one for patients and families, but one of being a hospice that is part of the community. Rowcroft’s large gardens are open to the public and are a popular community facility. There is never a sense of hiding away or being something that people only talk about when affected by it. The plans therefore include community facilities, a village hall and a day nursery. That creates opportunities for recreational activities and intergenerational connections, effectively making it a facility for the whole community with a unique side to it, and not just a hospice that people only attend if they need to be with a loved one.

Unsurprisingly, the plans have been widely acclaimed across our bay and have already received planning permission from Torbay Council. They could be under way in just over 18 months, providing support to our wider healthcare services, from a formal commission agreement with the integrated care service. The Minister will be pleased to hear that this is not a direct pitch for Government capital funding, although obviously if there were funding available, it would certainly help. That said, I would be delighted to welcome the Minister to Torquay so she can see at first hand the transformation the project will bring, not just to hospice and palliative care but to the future for that kind of care. A future that is about being not just part of the health and care system but at the heart of our community’s life, as well as being there when needed at a time when a loved one is passing away. I hope the Government will see it as a model for the future and one they want to get behind.

Given what I have already outlined, I would appreciate hearing the Minister’s responses to some specific points. As a matter of urgency, will she confirm how much of the £25 million children’s hospice grant each children’s hospice will receive in 2024-25, when they will receive it and how?

What assessment have Ministers made of the impact of integrated care board funding on children’s hospice care, and the risks of withdrawing the ringfenced grant? These services will work across regions; to ensure a more planned approach, will the Government direct ICBs to work with their neighbours on planning and funding children’s hospice and palliative care services?

More widely in the hospice sector, the variation in statutory funding between regions and hospices is stark. What thoughts have the Government had on ensuring a more consistent approach? Some hospice costs, including NHS pay rates, are decided by the Government. Would the Minister consider implementing a funding formula that would allow cost increases that are out of the hospice’s control to be reflected in local service contracts? Given the increase in costs this year, could the Government supply a simple fixed amount per hospice that forecasts a deficit? How do the Government see the future needs of palliative care being met? I am not requesting that hospices be publicly funded; the charity model offers many advantages and flexibilities. However, hospices must have predictability when planning for the future.

There is much more that I could say about the opportunities, challenges and pressures on hospices in South Devon, but I should draw my remarks to a close to allow the Minister adequate time to respond and perhaps take interventions. For families across South Devon, Rowcroft Hospice is a service that is not just valued, but treasured. It is a place where memories are made, conversations had that bring peace after a dispute that now seems petty, family events are held, news is shared and smiles may be raised, even as the end nears. In short, a hospice is a place where life is added to days, when days can no longer be added to life. We need to ensure that Rowcroft continues to be such a place for decades to come.

Seaton Community Hospital

Richard Foord Excerpts

Monday 13th November 2023 Commons Chamber

[Richard Foord (Tiverton and Honiton) (LD)]

I would like to welcome the new Secretary of State for Health and Social Care, the hon. Member for Louth and Horncastle (Victoria Atkins), to her place.

I rise to raise the pressing situation facing the community hospital at Seaton in the part of east Devon that I represent. I am very grateful for the opportunity to outline why plans to strip away a whole wing of the hospital pose a serious risk to the long-term viability of the hospital, and how small actions by the Government can unlock this space and provide huge benefits for the local communities.

Seaton Hospital is one of 12 community hospitals that provide vital services in my corner of Devon which were given over to NHS Property Services in 2016. Seaton Hospital provides a range of services and clinics that enable people to be cared for closer to home in their own community. I would like to take a moment to give hon. and right hon. Members an idea of the range of services that the hospital currently provides. They include a dedicated Chime audiology service, aneurysm screening, bladder and bowel treatments, and child and adolescent mental health services—we heard a lot about that in today’s health debate—as well as access to a dietician, ear, nose and throat specialists, general medicine, orthoptists, support for those with Parkinson’s, physiotherapy, podiatry, retinal screening, speech and language therapy, and stoma treatments. I could go on.

The hospital also acts as a hub for the growing number of so-called at-home care services. We appreciate that community hospitals have been increasingly moving over to services provided in the community at home. That includes provision for those who are frail and need regular care, or are reaching the end of their life. Indeed, the Seaton & District Hospital League of Friends supports the hospice at home professionals, who provide care to people and their families in those most difficult times of a person’s life or in a family’s life.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate. When someone evaluates what a community hospital does, they find that it is about much more than finance and making sure that the books balance. It is about all the things the hon. Gentleman has referred to. The community hospital in my constituency is where my three children were born some 30-plus years ago. It is where I took my youngest son when he broke his arm. It is where I took my other boy when he put his hand through a glass window and had to go to hospital for surgery. That is what a community hospital is about, and that feeling is replicated by every one of my constituents. When the hon. Gentleman speaks about his local community hospital, I am quite sure that he has the same passion, belief and commitment to that hospital, because it is part of the community, and that is how it is measured, not by finance.

[Richard Foord]

I am grateful to the hon. Gentleman for his intervention. His anecdotes about what that hospital has done for his family and community are absolutely the same sort of thing as I hear from constituents every time I speak to them.

Seaton Hospital was built in 1988 to provide better local access to medical care and treatment for people across the Axe valley. It serves people not only in Seaton but in Colyton, Colyford, Beer, Axmouth and other villages dotted around the east Devon countryside. Originally, the plan was that people would not have to travel so far for their treatment. Given that the Royal Devon and Exeter Hospital is perhaps 30 miles away—20 miles at least—people felt that acute provision was on their doorsteps, which is what they wanted.

[Simon Jupp (East Devon) (Con)]

The hon. Member is making a stand for a community hospital used by people in both our constituencies, and I congratulate him on having secured the debate. I live less than 10 miles from Seaton Hospital. So many residents raised funds to build the wing, which first opened back in 1991. Does the hon. Member agree that it would be so wrong for local residents to have to pay twice for a building that they helped to fundraise for and build?

[Richard Foord]

The hon. Member makes an excellent point. It is exactly right that Seaton Community Hospital was built by local people. Let me expand on that important point, because a lot of people have talked to me about this and I want to relay to the House the feelings they have spoken to me about at recent local community meetings.

The hospital was built over two storeys and updated in 1990 with an acute wing, which was funded not just 50% by the local community but 100% by local donations. The important thing to note is that the construction would not have been possible at all were it not for the contributions by local individuals. For example, the Seaton & District Hospital League of Friends had a scheme called “Be a brick: donate to Seaton Hospital”. People could make a small contribution—whatever they could afford—and get a little brick as a memento to demonstrate that they had contributed to Seaton Community Hospital. The charity is still a vocal champion of the hospital to this day. The project would not have happened had it not been for the generosity of the local people. What comes with that is a sense of ownership that I cannot really stress enough. There is a really strong feeling that the hospital does not belong to some amorphous NHS: it is their hospital. They paid for it, they were treated in it and it belongs to them.

Several weeks ago, I was contacted by the League of Friends charity after it learned from the Devon NHS that the plan is to hand over the two-storey wing from the Devon NHS to NHS Property Services. The charity was concerned that this could lead, eventually, to the selling off of the hospital wing, and even to its demolition. As soon as I heard that, alarm bells were set ringing for me. It is clear that Devon’s integrated care board is keen to wash its hands of the facility as quickly as it can. In essence, the facility is in special measures, and in a financially dire place. The wing is costing the Devon NHS about £300,000 a year, billed by NHS Property Services.

I was not all that familiar with NHS Property Services a year ago. I had heard of it, but I was under the impression that it was just another division of the NHS. I looked into it a bit further, and I found that it is responsible for the maintenance and support of most local NHS facilities. I was surprised to find that it is a Government-owned company, legally owned by one shareholder. The single shareholder for NHS Property Services is the Secretary of State for Health and Social Care. As of today, the hon. Member for Louth and Horncastle can congratulate herself on taking on NHS Property Services as her new holding. How can it be the case that a hospital built with the generous support of local people is now owned directly by NHS Property Services, rather than those local people?

In 2016, the Government transferred that facility over to NHS Property Services and implemented a consolidated charging policy to levy charges for rent, maintenance and service charges. Some of those charges are extortionate. We are talking about £300,000 a year, which is £247 a square metre. On paper, it might seem prudent to organise the NHS with some commercial expertise in charge of some of these facilities. However, we have to bear it in mind that the people running NHS Property Services are not necessarily thinking about it through the lens of health and social care; they are thinking about how they can maximise the utility of space and make savings to put money back into budgets.

That is worrying, because what I am hearing is that the offer being made to NHS Devon is, “If you wash your hands of this facility, you will receive 50% of the proceeds of the sale”—that will be to the NHS Devon integrated care board—“and 50% of the proceeds will go back into central coffers, back to Whitehall and back into the very large pot that is the NHS.” The House can imagine what that is like for an individual constituent in my part of east Devon, who has contributed perhaps tens or hundreds of pounds—as much as they could afford—in decades gone by, perhaps through a direct debit or regular payment, to maintain the facility. To hear that those decades of investment will be put back into a big pool in London, a long way away, is pretty sickening.

There has been an understandable backlash from people right across my corner of Devon. I have been to a couple of public meetings in recent weeks since the news broke. At Colyford Memorial Hall a couple of weeks ago, there were more than 200 people. It is a cliché to say there was standing room only, but there was no standing room—there was a long queue of people outside in the rain wanting to get into the meeting. People had one overriding feeling that they wanted to convey to me, and that they wanted me to convey to the Minister and to others gathered here this evening: they created this hospital and they are deeply offended by the idea that it might be taken away. What put salt into those wounds was the idea that that should happen with zero public consultation.

[Wendy Chamberlain (North East Fife) (LD)]

My hon. Friend is making a passionate speech on behalf of his community. What strikes me is that when the community came forward and made those contributions or bought those bricks, they did not do so to save the hospital at that point. I am pretty sure, like the hon. Member for Strangford (Jim Shannon), that they made that contribution to maintain the hospital for future generations. I am not surprised that it feels like a betrayal to my hon. Friend’s constituents.

[Richard Foord]

I very much thank my hon. Friend for her contribution. She is exactly right. I point to two specific conversations I have had with constituents recently. The first was with someone who lives in Seaton, who was close enough to the hospital that she could walk there. Her husband died in the hospital and she was able to go and see him in his final days. She welled up—more than that, tears rolled down her cheeks—as she told me about her husband, who she was able to see in his final days.

Now we have moved to a situation in which patients are cared for at home. Of course, that means that some of the staff previously based out of the community hospital are driving to people’s driveways and providing that care in their homes. That works for some individuals, but the other day I had a lady in my surgery who was almost shaking with nervousness because her husband, whom she loved dearly, had just been discharged from the acute hospital in Exeter and she was charged with looking after him but did not feel able to look after his needs, as he was overcoming his operation towards the end of his life. We are putting some of our constituents in a really difficult situation that they do not feel equipped for.

The reason for the beds being removed from the hospital in 2017 related to so-called workforce issues. There was a substantial consultation of local people in 2017 when beds were removed from local hospitals, but I fear that following that consultation, which showed the outrage and indignation of local people, the NHS does not want to get involved such a consultation exercise again, hence the desire for the ICB to get shot of the building as soon as possible.

The ICB was talking about getting shot of it by the end of this calendar year, although that has gone to Devon County Council’s health scrutiny committee, so it may be pushed into next year. What we need tonight is an intervention from the Minister in relation to NHS Property Services, which is charging a clinical rate for a space that has not been used for acute medicine—it has not had clinical beds in it—since 2017. Organisations are coming forward with a desire to use it not for clinical use but as a care hub to provide other services.

I want to make hon. Members aware of how those clinical beds got removed in the first place. In 2017, there was deep concern that the removal of the beds was an arbitrary decision made following a last-minute intervention by the then right hon. Member for East Devon, Hugo, now Lord Swire. In fact, it is revealed in a book by his wife, Sasha, that Seaton Hospital was to be kept open, with its beds maintained, but, because of that last-minute intervention by Hugo Swire, the bed closures moved to Seaton and the Sidmouth Hospital beds remained.

As a result of that decision, there was no additional funding to set up extra services at Seaton. Instead, the ICB began charging this exceedingly high rent for an empty space. What we really need to do is reduce that rental fee from its clinical rate to one that acknowledges that there are community alternatives. The palliative care nursing team can operate out of this space, and organisations such as Restore and hospice at home carers can work out of it, too. The friends of Seaton and District Hospital are coming up with a strong business plan, but they do need more time to develop it and a concessionary rate—not the clinical rate—to operate from it. If no solution is found, the ward is most likely to be either sold off or demolished. Again—I cannot stress this enough—we need to do this for the people who feel that they paid for the hospital.

There is a precedent for it, and I am grateful to the hon. Member for St Ives (Derek Thomas) for letting me know that the hospital in Cornwall was saved from the jaws of NHS Property Services. However, there is a big difference between what I am proposing for Seaton and what happened at St Ives. St Ives hospital was paid for by a single philanthropist. As we have heard, Seaton Hospital was paid for with contributions—or subscriptions —from thousands of people.

[Jim Shannon]

The widow’s mite.

[Richard Foord]

Exactly.

Finally, when it comes to healthcare infrastructure in rural areas such as mine, it is so much harder to rebuild something once it has been removed than to maintain it. We saw in coastal and rural communities such as mine the damage that the closure of cottage hospitals caused, and the impact of removing beds from community hospitals. We must put a stop to that, before our rural healthcare centres are left empty skeletal shells of their former selves, where they were once hubs of love and care. I am looking forward to the Minister’s response and hope that she will agree to work constructively with me, as Seaton’s MP, to ensure a fair deal for local people and to protect our hospital for the people who bought and contributed to it.

--- Later in debate ---

[Helen Whately]

It is important to note that NHSPS operates on a cost recovery basis. That means any reduction in its charges counts as a loss to the health budget if it is not directly offset by actual cost reductions in the facilities. As the hon. Member mentioned, the annual charges for the vacant space in this facility are approximately £300,000, of which £140,000 is the rental charge. The rest is spent on a share of the utilities, business rates, maintenance and cleaning costs for the property.

[Richard Foord]

I am grateful to the Minister for explaining the charge-back system. Could she explain why the NHS is charging the NHS and hence the NHS cannot have this space, and why it cannot be used for health purposes? Could she explain the charging mechanism a little bit more please?

--- Later in debate ---

[Helen Whately]

I will make a bit of progress, if that is all right.

As I outlined, the ICB is required to pay for the costs and it is not sustainable for the ward space to remain empty for a further lengthy period of time. When an ICB decides there is no long-term healthcare use for an asset, it will usually be sold to allow the funds to be reinvested elsewhere. I have been told that that is not the plan in the case of Seaton community hospital, not least because half the building is an operational health facility and the ICB is fully committed to keeping those services open. I also appreciate that a huge fundraising effort was put in by the local community to build the wing at the hospital in the first place, a point that my hon. Friend the Member for East Devon (Simon Jupp) made when he intervened earlier, and so selling the facility would not be what the community wants.

We know that providing high-quality care and support in the community benefits patients, and their carers and families, helping people to stay well and independent for longer. Across the country, we have achieved a lot as part of our commitment to move more care out into the community. For example, urgent community response services are doing a great job of helping to keep people out of hospital when they are at risk of a crisis. Virtual wards or hospital-at-home services are providing hospital-level care in people’s own homes, helping to avoid admissions to hospital and allowing earlier discharge, and ensuring extra support is there if somebody is concerned about being discharged home, or, as I heard the hon. Member mention, is concerned about a family member being discharged home.

[Richard Foord]

I am grateful to the Minister for raising the concept of the virtual ward in this context. It reminds me a little of conversations that I have had with constituents in recent months about the virtual shopping experience, the virtual rail ticket purchasing experience, and the difficulty that they are having in dealing with humans. I think that the last thing people want when it comes to health and social care is “virtual”. They want the human touch.

[Helen Whately]

I can only encourage the hon. Gentleman to visit a team that supports a virtual ward, and speak to some patients who have been cared for through hospital at home or virtual wards. I have done both, and the feedback from patients is phenomenally positive. If someone is concerned about being discharged and supported in this way, it does not happen, but many people would much rather recover in their own homes with that support than be in a hospital where it is hard to get a good night’s sleep because there so much going on around them. Moreover, while people recover in their own homes, beds are freed up for people who really need acute hospital care on site.

A third model that is doing very well in helping people to receive care close to home is the proactive care model delivered by multidisciplinary neighbourhood teams. These are real game-changers, helping people to live independently and stay out of hospital. The teams consist of—among others—doctors, nurses, care workers, allied healthcare professionals, all coming together to ensure that people have the care that they need in order not to be going in and out of hospital, as sometimes happens when people become unwell.

While I fully understand the hon. Gentleman’s frustration, I have been assured that the integrated care board, local providers and NHS Property Services are working together to resolve the situation at Seaton Hospital to ensure that facilities—and, indeed, funds—are put to good use for patients.

Question put and agreed to.

Building an NHS Fit for the Future

Richard Foord Excerpts

Monday 13th November 2023 Commons Chamber

[Amy Callaghan]

I absolutely would like to see the same for Scotland. The Barnett consequential system in itself is quite frustrating, because we do not see the full complement we should get because of how the British Government exercise spending decisions. I would absolutely like to see a different funding structure exercised down here. The way it is spoken about is complicated in itself, and a bit of truth around that would be useful.

I have been struggling with the image of the King delivering his speech from his gilded throne while innocent people in Palestine are dying. It feels a ridiculous thing for this Parliament to have been focusing on. We are witnessing the biggest humanitarian crisis that many, if not most of us, have ever seen. It bears witness to how soulless this British Government truly are. Children are dying, refugee camps are being bombed and hospitals are being destroyed. For each second that Members throughout this House fail to call for a ceasefire, more innocent people are dying in Gaza.

Not just a humanitarian pause but a ceasefire is necessary. Riham Jafari of ActionAid Palestine so aptly described the difference between a humanitarian pause and a ceasefire:

“What use is a four-hour pause each day to hand communities bread in the morning before they are bombed in the afternoon?”

Innocent men, women and children in Palestine continue to die. I make a plea to colleagues on both sides of the House: walk through the Lobby with us on Wednesday night to vote for a ceasefire. They need you to show leadership. We need to show leadership and vote for the SNP’s common-sense humanitarian amendment to the humble address.

In preparation for this debate, I found myself reflecting on the words inscribed on the mace of the Scottish Parliament: “Wisdom, Justice, Compassion and Integrity”. The mace is not just about tradition, and it is not a bit of a pantomime like in this Parliament. In Holyrood, the mace is there to signify the relationship between the people, the Parliament and the land.

No institution better represents the link between the people and the state than our precious NHS, but being tied to this financial Union means that our NHS is suffering terribly. We have workforce shortages, medication shortages and equipment shortages—shortages, shortages, shortages. I got into politics because of the rampant health inequalities I saw in my part of the world when I took unwell as a teenager. We all know health outcomes are impacted, whether directly or indirectly, by the quality of our support network. I saw first-hand the effect of poverty on outcomes. That is why I am so proud that our SNP Scottish Government implemented the young patients family fund, which helps to prevent income from being a barrier for families being able to support a young person through ill health. Scotland is leading the way in transforming lives and outcomes with that fund.

It would have been nice to see some flickers of hope and progress woven through the King’s Speech, but given the British Government’s lack of willingness to learn from good practice elsewhere on these isles, it is relatively unsurprising not to see it. The pomp and pageantry of this place, its traditions and its reactionary main parties seem to me to be a distraction from the real work and hard conversations that neither of the two main parties want to have. Instead, we have a celebration of the dance we call debate in this place.

I will now reflect again on the words inscribed on the Mace of the Scottish Parliament. Let us take a look at each and see whether they apply to the British Government. I will start with the wisdom that is being shown—or not shown—in this place where Brexit was forced through, despite the broken promises it was built on. What has come with that wise decision endorsed by both the Government and the Labour party? We have severe medicine shortages, meaning that people are unable to access vital treatments such as attention deficit hyperactivity disorder drugs and hormone replacement therapy, as well as a shortage of staff to supply and distribute them. That oven-ready Brexit deal that the public were promised was lacking one key ingredient: wisdom. My constituents in East Dunbartonshire applied wisdom in advance when they overwhelmingly voted to remain within the European Union, but the structure of the Union meant that their voice was ignored.

Moving on to justice, where is the justice in there being so many material changes of circumstances since the 2014 referendum, while the British Government continue to deny the people of Scotland the right to choose our own future? Some might say that that is an injustice.

Moving on to compassion, there are many ways in which I could question the compassion of this place, but there is nothing more timely or truly horrific than the ongoing attacks on civilians in Gaza. We are witnessing the biggest humanitarian crisis many of us have seen in our lifetimes, and this place has rightfully expressed compassion for those killed and suffering in Israel, yet the compassion is lacking for those children in Gaza. Each day that this place fails to unite behind a ceasefire, children die. Where is the compassion for those children?

[Richard Foord (Tiverton and Honiton) (LD)]

Would the hon. Member get behind a unilateral or a bilateral ceasefire?

[Amy Callaghan]

I would get behind a ceasefire. We are talking about a ceasefire.

--- Later in debate ---

[Mike Amesbury (Weaver Vale) (Lab)]

I pay tribute to our national health service and social care staff, be they in Cheshire, Merseyside or elsewhere across Britain. Of course, while many in Downing Street partied, those staff went above and beyond and sacrificed so much every day—we must not forget that; the public inquiry is certainly shining a light on it—and, importantly, they continue to do so.

It is no secret that our NHS is facing the worst crisis in history. Urgent action is needed to make our cherished healthcare system work again, but the Government provided no solution in the King’s Speech, with 21 Bills that were heavy in rhetoric but light in substance. Where was the Bill on mental health, which we have long awaited and the Government have promised time and again?

Bizarrely, after 13-plus years of failure, the Prime Minister is trying to paint himself as a vehicle of change, while recycling a failed Prime Minister from the past, whose only notable recent success was to get himself on the payroll of Greensill Capital, which came at a real human cost of 305 job losses in the Daresbury Park area of my constituency. This is a company—sorry, a failed company; a former company—that is now subject to an investigation by the Serious Fraud Office. We are still dealing with that sorry affair, yet bizarrely, that individual is now appointed to the Government. To me and my constituents, it sounds like the same old entitled Tories time and time again, with no responsibility to anybody, putting arrogance above all. It is the same old Tories—the same old Etonians—and one of them is coming back.

The Conservatives have no answers on how to save the NHS. This Government are failing millions of patients and NHS staff across the country. Waiting lists are out of control, staff are burned out, and people are literally losing their lives. Too many of our constituents are waiting longer than ever for operations, in A&E, for ambulances, and when trying to get doctors’ appointments. The system is broken; the Government broke our NHS. We only need to look at their own figures: recent statistics show that the NHS backlog has hit a record high, at 7.8 million. That backlog is 600,000 larger than when the current Prime Minister made his pledge—one of his five pledges—in January.

We on the Labour Benches know that there is a plan. There is a sizeable pot of money available from non-doms, the very people who, bizarrely, the Prime Minister seems to want to protect. It is almost as though he has a vested interest in non-doms—I cannot imagine what that might be. That money could be used to power up the frontline resources that we need to get waiting lists down. Why not adopt the Labour plan? Go and steal our plan. Let us provide 2 million more appointments by paying staff extra to work evenings and weekends, paid for by abolishing the Prime Minister’s beloved status of non-dom. Just do it—steal it! Do the right thing. Of course, that is not going to happen.

The NHS shortfall affects a number of other areas across the health landscape, especially dentistry in my constituency and throughout England. We know that 90% of dental practices in England are closed to new NHS routine patients, creating dental deserts. That is certainly true in the Halton and the Cheshire West and Chester parts of my constituency. People who have a little bit of extra money in their pockets are forced to pay for expensive payment plans in the private sector, but as has been well documented across the Chamber today, many are resorting to DIY treatment. It is an absolute scandal; it is Dickensian. In this day and age, everyone should have the right to receive dental treatment when they need it. That is a fundamental principle of the NHS—the NHS that we founded, and that we will protect and save.

Just as it is very challenging to get a doctor’s appointment, unfortunately the principle behind NHS dentistry continues to be severely undermined. I recently visited Leftwich Community Primary School, a brilliant school in my constituency with great teachers and support staff. The joint headteachers raised the desperate attempts that are made to try to get NHS dentists for pupils at the school. The teachers are going the extra mile, trying to get NHS dental appointments for children in the local community. What will the Government do to make sure there are enough dentists across England, including in Cheshire and Merseyside? Why not adopt Labour’s plan for an additional 700,000 dental appointments—quite a significant number, although it seemed to be pooh-poohed by a Minister earlier in the debate—by closing private equity loopholes? That is another costed plan—steal it! Do the right thing. Of course, the Government will not.

In my constituency, we have hospitals that badly need to be upgraded and modernised. Our bid for a new Halton campus hospital was snubbed by another Health Secretary—third time unlucky—while Leighton Hospital, which serves the Northwich part of my constituency, was successful only because it is literally falling down. It is propped up by scaffolding; it is riddled with reinforced autoclaved aerated concrete. That is how it got on the programme for the 40 new hospital builds, which of course is a work of fiction in itself. I will be asking another Secretary of State for Health and Social Care—another one was announced today; I had forgotten about that—when the people of Halton can expect to hear some good news about that desperately needed hospital rebuild.

[Richard Foord]

I was interested to hear the hon. Member mention RAAC in his speech. I have heard that there is a hospital in Harrogate that needs £20 million of repairs because of RAAC, but the Government are requiring that hospital to bid for the funding, rather than just giving it the funding. Does the hon. Member think that is right?

--- Later in debate ---

[Richard Foord (Tiverton and Honiton) (LD)]

I intend this evening to talk about rural and coastal healthcare, community hospitals, social care and NHS dentists. Right across the country, our NHS is creaking. In rural areas such as the one that I represent in Devon, many people are finding it almost impossible to get timely care. Despite that, there were almost no announcements in the King’s Speech of new legislation to support the NHS in rural areas. I really am wondering, given that I represent a corner of Devon, what was in this King’s Speech to provide for healthcare in the countryside. We often hear about acute challenges in urban areas, especially when it comes to vital services that we perhaps do not need to travel very far for, but coastal and rural areas tend to be places where older people retire to and so have a higher population of older people.

Last week Sir Chris Whitty, the chief medical officer, said that the elderly boom will be in rural, largely coastal areas. He said:

“We’ve really got to get serious about the areas of the country where ageing is happening very fast, and we’ve got to do it now...otherwise we will end up with large numbers of people leading much more dependent lives”—

that is, lives that are more dependent on the state and on taxpayers. We really need to get a grip of this. Sir Chris wrote:

“Improving quality of life in older age sometimes means less medicine”.

It might be that older people want to go to hospital, but not to intensive care. It might be that they want to have treatment, but not an operation. It seems to me that Sir Chris Whitty is encouraging us to listen to what older people want.

I held a listening exercise over the summer in which I visited 34 village and town halls, and I am certain that, more than anything else, people in my part of Devon want good community hospitals and good care close to their home. I heard that they do not want to have to travel 30 miles to the nearest acute hospital in Exeter, on a bus that can take up to 90 minutes, to see a loved one or to have an operation. Going to hospital is a huge burden for people living in rural areas like mine, where public transport is poor and declining in quality, meaning that people spend a whole day travelling to and from hospital, which is a huge undertaking for older people.

That is why community hospitals are vital. They offer bases for treatment, helping to support people in their own community. Sadly, we have been losing these centres in recent years. In my corner of Devon, we have seen the hospitals in Seaton, Honiton and Ottery St Mary suffer swingeing cuts. The cuts to the number of beds, made in 2017, were fought vocally by local people, and they are having lasting consequences.

My Adjournment debate will focus on Seaton Community Hospital but, in the meantime, I will talk about two other rural health challenges: social care and dentistry. The cost of providing care at home is higher in rural areas, both to those who pay for it and to those delivering it, because they are having to drive between appointments. That is why the Liberal Democrats are calling for a carers’ minimum wage, with an additional £2 an hour boost to the minimum wage paid to carers.

The situation for dentistry in Devon is even worse. Local NHS dentists are so up against it that not a single dentist in all of Devon is taking on new NHS patients. Healthwatch England reported on seven of the NHS’s 42 subregions that are not taking new dental patients:

“Of all of these areas perhaps the worst affected is Devon, as there are currently no practices showing as taking on adult or child patients.”

This means that people are having to live in agony; having to travel huge distances to far-flung destinations—I heard one constituent say that it was recommended that they travel to Gloucester for an NHS dentist; having to pay huge sums of money that they do not have to go private; or having to perform terrible, dangerous DIY dentistry to remove their own teeth.

The Government would prefer to be silent about this issue. We have a ticking time bomb of retirement looming, and the Conservative Government have rejected Liberal Democrat calls to reform the NHS dental contract or to set out a clear plan to recruit and train the thousands of dentists that we need.

Those challenges are specific to rural communities, but today I am also talking about challenges that are specific to coastal communities. The final subject I want to cover is therefore sewage dumping, which can be damaging to health. I know people who have become sick after swimming off the east Devon coast. People should not have to risk sickness on Devon’s beautiful beaches.

There was a raw sewage spill at Sidmouth on 10 September 2022, despite the water quality report by Surfers Against Sewage finding that there had been no rain over the previous 48 hours. What did South West Water, the water company responsible, have to say? It said the spill was a “false alert” due to wildlife brushing over the sensors on the combined sewage overflow monitor. What kind of Government would set up a regulator that was prepared to accept that as an explanation? Liberal Democrats want to see water companies overhauled and reformed into public benefit companies. We need to put the health and wellbeing of local people ahead of corporate greed and shareholder profits. That will stop people getting sick and ensure that our favourite beaches remain attractive places for tourists.

I wish to close by reading out the words of David Cameron. When he retired, he talked about how he did not think he was the right person

“to try to be the captain that steers the country to its next destination.”

That can apply to the whole of this Conservative Government.

Future of the NHS

Richard Foord Excerpts

Tuesday 24th October 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

It is an honour to serve under your chairship, Mr Pritchard. The NHS is one of our country’s defining achievements. From the ashes of the second world war, we built a world-leading health service, delivering free care at the point of use for everyone in the country. My points today are going to focus on waiting times, dentistry and the link to social care.

In recent years, this grand vision has been steadily eroded. More and more people are struggling to get the care they need, and waiting lists continue to spiral. As of two weeks ago, 7.75 million people were on NHS waiting lists. Nearly 9,000 people in England are estimated to have been waiting more than 18 months to start their treatment, while the number of people waiting for more than a year was just under 400,000. I can think of specific examples. I represent over 75,000 people in my part of Devon, one of whom is David Crompton from near Bampton. David is a deer farmer, and he needs to be mobile to do his job. He needs a knee replacement. He wants to be useful to the economy and to society, but he has been told that it will probably be two years before he gets a knee replacement.

With cancer waiting times, the situation is little better. Every single cancer waiting time target was missed, and ambulance and A&E waiting times increased. This is a shocking situation, which will only lead to more long-term problems. We know that every day that someone waits to start treatment, or every time that someone is stuck in the back of an ambulance or an A& E department, it is because there is not a bed for them to be transferred to, which leads to worse outcomes. Then, of course, long-term health conditions can develop.

Obviously, this is not just a problem in hospitals; it is also a problem in other areas, such as primary care and social care. On primary care, the Liberal Democrats are calling for 8,000 more GPs. A very astute constituent of mine, a medicine student called Jonty Eaton-Hart, wrote to me recently. He has written a lot on rural and remote health. He pointed out that at the moment in general practice, the situation is almost similar to that of a frog being boiled in a pot, whereby there is so much pressure now on people working in general practice that at some point the frog is going to hop out of the boiling water. Retention of staff is absolutely key.

As I say, Jonty has written a lot about rural areas. In rural areas such as my corner of Devon, the very notion of NHS dentistry is another area of health that feels like some sort of vaguely recalled legend from years gone by, with people being left in agony because they cannot get an appointment. So many constituents have written to me complaining that they have to pay huge sums to travel long distances. But if people cannot travel long distances or cannot pay the large sums required for private treatment, then they have to suffer in agony.

This Conservative Government simply cannot go on as if nothing is wrong. It is plain that the dental contract needs reform, but the fact that they are not reforming it properly suggests that they simply do not care. They cannot go on pretending that somehow dentistry is available everywhere on the NHS; that is simply not the case in rural areas.

Another area that needs a major rethink is the way in which social care is integrated into our national health service. Of course, such integration has notionally happened now that we have a Department called the Department of Health and Social Care, but actually that is just rhetorical; we are not seeing proper integration of health and social care.

The Government have repeatedly shelved plans to overhaul social care and instead are content to tinker round the edges while people are unable to get the care they need. We have seen chronic workplace shortages; there are over 150,000 vacancies in adult social care. Yet the Government have repeatedly rejected Liberal Democrat proposals for a carer’s minimum wage, which would see an uplift of £2 per hour in the minimum wage paid in these crucial social care jobs.

The Liberal Democrats reckon that investing an extra £5 billion in social care will lead to savings in the NHS—not to the same level, of course, but we reckon that that would bring £3 billion in savings for the NHS. Therefore, a £5 billion investment in social care would actually involve only a net cost of £2 billion. At present, publicly funded social care is mainly financed through local government. We know that local government finances have been squeezed really hard in recent years, so we have to shift some of this burden of taxation back to Westminster.

The Liberal Democrats are also calling for cancer patient treatment to start within two months of an urgent referral. That ought to be the case now. We are calling for an extra £4 billion to be spent over five years in this area. My right hon. Friend the Member for Kingston and Surbiton (Ed Davey) was exactly right when he said:

“Voting Conservative is bad for your health.”

LGBT+ People and Spouses: Social Care

Richard Foord Excerpts

Tuesday 12th September 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Robert, and to respond to the debate on behalf of the shadow Health and Social Care team in my first outing as the newly appointed shadow Minister of State for Social Care. It is always good to see the Minister for Public Health in his place.

I sincerely thank my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) for securing the debate and for all her work on this important subject. Her contribution this afternoon was heartbreaking —the way in which her constituent was treated was utterly shameful. I also thank my hon. Friend the Member for York Central (Rachael Maskell) for her contribution. She ended on such a powerful poem, which speaks to so many who suffer in care home settings.

The Care Quality Commission guidance for all providers of adult social care clearly states that people using care services

“must not be discriminated against in any way and the provider must take account of protected characteristics, set out in the Equality Act 2010.”

As we have heard today and as we know from other studies, however, that is not always the case.

A survey conducted in 2017 found that 23% of open LGBT+ respondents who had been in a care home or other form of institutional care reported that being gay, trans, bisexual or lesbian, or having other protected characteristics, had a negative effect on the care that they received. Those examples are varied, but each and every one of them is concerning. Some respondents to the 2017 survey said that they felt invisible. Other responses related to use of language—for example the assumption that a partner or spouse is of the opposite sex, when that is not necessarily the case.

At their worst, the experiences of LGBT+ people in care home settings can be traumatic, as demonstrated by the story of Noel Glynn and his partner Ted Brown, who is a constituent of my hon. Friend the Member for Dulwich and West Norwood. Before he died, it is reported that Mr Glynn, who had dementia, suffered bruising across his body and had a cigarette burn on the back of his hand because of abuse from care staff. Other residents warned his partner Ted not to reveal to staff that he and Noel were a couple, saying, “That won’t be good for either of you”.

Mr Glynn and Mr Brown sued Lambeth Council, but Mr Glynn very sadly died before any compensatory payments were made. This case is beyond abhorrent. I hope the Minister will set out how it happened and what steps the Government are taking to ensure that it never happens again. The Minister will know that the Care Quality Commission does not currently consider the extent of homophobia or transphobia in inspections, despite its fundamental standards. Following this case, will the Minister look again at that guidance?

More generally, what this issue comes down to is the importance of personalised care. A report by the Women and Equalities Committee published in 2019 points to research showing that 72% of care workers do not consider sexual orientation to be relevant to one’s health needs. That same report states that

“most health and social care professionals feel under-equipped to deal with LGBT people’s needs rather than intentionally discriminating.”

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 are clear on this subject. Regulation 9 states that people using a service should have care or treatment that is personalised specifically for them. It is important that care providers respond to the serious concerns raised by LGBT+ people and ensure that those accessing services feel respected and safe, and benefit from care that is tailored to their needs.

My questions to the Minister are as follows. Given the extraordinary shortages in adult social care staff—sitting at around 165,000—what work are he and his Department doing to protect the principle of personalised care? Further, what steps is the Department taking to monitor the experiences of LGBT+ people in social care settings? In the 2018 LGBT action plan, the Government pledged to develop best-practice guidance for monitoring and to make this openly available to the public sector. Why were these pledges not implemented? Have they simply been abandoned alongside a plethora of other Government commitments, from banning conversion therapy to tackling waiting lists? Finally, LGBT+ organisations have called for better guidelines and staff training for those working in care settings. Can the Minister outline whether the Government support these calls?

The next Labour Government will address the vacancies in social care by delivering a new deal for care workers, guaranteeing fair pay, training, terms and conditions and career progression.

[Richard Foord (Tiverton and Honiton) (LD)]

I am curious to know from the shadow Minister what fair pay in the social care sector would be. What does he think of the Liberal Democrat proposal to pitch an additional £2 per hour minimum wage for social care workers?

[Andrew Gwynne]

If the hon. Gentleman had been at the TUC conference today, he would have heard the shadow Deputy Prime Minister, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), outline precisely what Labour’s fair pay deal will be for the social care sector, but we need to go beyond that. We need to ensure that social care becomes a valued profession again, rather than just assuming that agency staff can fill the vacancies. We need to make sure that social care once again has parity with the rest of the healthcare system and that care workers want to work in the care sector not just because of pay, terms and conditions, but because it is a profession—which, sadly, many feel it no longer is.

We will work in partnership with users and families and develop a set of national standards based on existing minimum entitlements and legal rights, including legal rights that exist in the Equality Act 2010—a piece of legislation of which I am fiercely proud, and which the last Labour Government took through Parliament and put on the statute book. We need to make sure that all service delivery, particularly in social care, meets the ambitions and legal expectations of the Equality Act—sadly, that has let down so many LGBT+ people in the social care sector, as we have seen from the statistics in the surveys that I have cited this afternoon.

We would also ensure that our commitment to raise standards right across the sector is upheld by requiring all care providers to demonstrate financial sustainability and, crucially for this debate, to deliver high quality care for service users before they are allowed to receive contracts from local authorities, making sure that local authorities commission care providers who are capable of delivering the care that people need at the standard we should expect. That would result in more personalised and ultimately higher-quality care for all individuals.

In 2023 people who are lesbian, gay, bisexual, trans and others should not feel ostracised by a system that is there to support them. They should not feel ignored and that their personal needs are not being met. Ultimately, they should not feel the need to hide the fact that they are gay, lesbian, bisexual, trans or other. I hope that the Minister will agree with me that we can get to work on delivering that higher standard of care for all service users. The testimony that we have heard today from my hon. Friend the Member for Dulwich and West Norwood should stand as that end point. Never again should somebody from the LGBT+ community be treated as we have heard. “Never again” should be more than a slogan. It should be deeds.

Under-age Vaping

Richard Foord Excerpts

Wednesday 12th July 2023 Commons Chamber

[Richard Foord (Tiverton and Honiton) (LD)]

I join Members from across the House in expressing concern about the way in which vaping is marketed to, and taken up by, children.

We have heard that vaping is a useful tool to help people to quit smoking, and that it is safer than smoking tobacco and cuts down the chances of developing conditions such as cancer. However, the Liberal Democrats are deeply concerned by the rise and prevalence of single-use disposable vapes, which are explicitly targeted at young people, be it through the use of brightly coloured advertisements, a range of playful colours or their placement near the front of supermarkets. We must ensure that young people do not become addicted to those products, and that vapes do not become a gateway to smoking. I am grateful to the right hon. Member for Romsey and Southampton North (Caroline Nokes), who, during her excellent speech, referred to the location of vape bars in supermarkets. I will expand on that point by talking a little about my own experience of it.

A few months ago, a parent of a student at Tiverton High School in Devon reached out to me as he was deeply concerned by the rise in the theft of vapes from our local Morrisons supermarket, which is just a short walk from Tiverton High School, making it easily accessible before and after school, and perhaps during lunch breaks. I visited the store and found that the vape stand was indeed right next to the shop entrance, offering a range of single-use disposable vapes. My staff spoke to the staff at the store, and it emerged that that spot was, yes, chosen by the vendor. The vendor specifically insisted on the vape stand being at the front of the shop in that way, and paid extra for it. As is the case in other supermarkets, the security team were not regularly stationed by the front of the shop, so it seemed ludicrous to me and my team that those products were placed so close to the door and left unprotected.

We took up the cause and campaigned with community representatives, including those from Tiverton High School, and spoke with staff from Morrisons to get that changed. After a short investigation, the store offered first to have a security guard stand next to the vape stand, but clearly, that was not enough. I am pleased to say that, after a lot of pressure, the vapes are now kept safely behind security doors, which are locked during school opening and closing periods on weekdays, meaning that vapes can be bought only from the kiosk.

That is very welcome news. I thank and pay tribute to Frazer Gould, from my part of Devon, who raised this issue with me. I do not think it should take a constituent lobbying a Member of Parliament, and that Member of Parliament getting directly involved, to ensure that those addictive products are not left openly accessible to young people.

[Kirsten Oswald]

The hon. Member is making an excellent speech. It is very helpful of him to point out the constructive actions of his constituent in this regard, although he is correct to say that it is we who should act. We should appreciate all the constituents of ours who are very focused on this, including my constituent Laura Young, who has done so much work to try to get vapes off our streets.

[Richard Foord]

I am grateful to the hon. Member. I also pay tribute to other constituents of mine: many of the young people who attend Tiverton High School. I do not want to mischaracterise them as people who are only out to steal vape bars from the supermarket at lunch times. I have been to that school several times, and there are some brilliant pupils there. Many of them are aware of the risks of becoming addicted to vape bars.

The campaigners, the high school and my team have worked with Morrisons and we have got that arrangement in place, but that is clearly just one arrangement with one supermarket. What we definitely need to do is think about single-use vape bars in the round. It is clear that we need to ban the sale of single-use disposable vapes, clamp down on the appealing packaging and the advertising of those products, and ensure that the shameless vaping companies cannot get our children hooked on those addictive devices.

Defibrillators: Public Access

Richard Foord Excerpts

Tuesday 4th July 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

I pay tribute to the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), who set out some moving thoughts about the importance of altruism and caring for other people in their moment of need, and about how the Government can perhaps help communities to enable individuals to help other people.

I want to pay particular attention to two aspects of best practice in my constituency and in broader east Devon, and I will close with one ask of the Government. The two examples of great ideas relate to Devon Air Ambulance Trust and Axe Valley Runners club. I met Devon Air Ambulance Trust here in Parliament last winter. The trust let me know that it is running CPR training and training on how to use a defibrillator. It invited me along to Sidmouth rugby club to get some training on CPR and how to use a defibrillator. It was great, because I had not done much of that sort of training since being a Scout as a young lad. It was brilliant to see how much progress has been made in resuscitation and how much more can be achieved these days with technology that we did not have in the 1980s and 1990s.

The Devon Air Ambulance Trust has a “Help with all your Heart” campaign, which seeks the best possible outcomes for patients who suffer a cardiac arrest. Part of the objective is to provide more of the equipment, as well as trying to train people such as myself in how to use it. The trust has put AEDs outside its charity shops on high streets, and it is working with town councils in east Devon to enable better access to AEDs.

The second organisation that is doing great stuff in my part of Devon is Axe Valley Runners club. Earlier this week, as covered by the Midweek Herald newspaper, the club did a “defib dash”. A defib dash is a bit like orienteering, for those who know what that is. The idea is that the runners go off in groups with a map to find a number of defibrillators. They go on various routes, competing against one another, to see who can get back to the beginning having found the most defibrillators. They ran around Seaton, Axmouth, Beer, Colyton and Colyford, covering a big chunk of the Tiverton and Honiton constituency. I pay particular tribute to Heather Simmons, Claire Warner and Sarah and Ronnie Whelan, who deserve credit for that novel and creative idea.

My third and final point is the ask. It would not be necessary for community groups to come up with these fantastic initiatives if there was better understanding of where defibrillators are and how to use them. The hon. Member for Erith and Thamesmead has mentioned the Complete The Circuit campaign being run by the Express. The absence of a complete register of AEDs is a particular issue for rural areas such as my part of Devon. We think that there are 70,000 AEDs on the national register, but our understanding is that there are between 100,000 and 200,000 AEDs in existence. We are, therefore, nowhere near having a good idea of where defibrillators are located. This is an important issue. If someone comes across somebody who has had a cardiac arrest, one of the first things that the ambulance service will do when they call 999 is direct them to the nearest AED. In a rural area such as mine, however, the service might think that the nearest AED is miles away, without knowing that there is one just a few hundred metres away from the incident. As the Express has said, we need to Complete The Circuit. We need a full and proper record of where AEDs are located.

I am a Liberal Democrat and we do not really believe in intervening in matters in which the state need not get involved. In this instance, however, I have been racking my brains for reasons why the Government might not want to legislate or intervene to require community groups to register AEDs on a national database. I have asked the chairman of Sidmouth Town Council and other community groups about the arguments against having a comprehensive register of AEDs, but I have not yet heard a sound argument why we should not require everyone who, through the kindness of their heart, buys an AED to register it so that the ambulance service can direct people to all available AEDs.

In summary, fantastic work is being done outside the House by community groups, but we need a central register and it has to be as comprehensive as possible.

--- Later in debate ---

[Will Quince]

I have not been the Schools Minister for many months, but I will gladly ensure that the relevant Minister—or I, having accessed that information—gets it to the hon. Lady.

I remember that a key point in the design of the scheme—this touches on a point made by many hon. Members—was that providing an AED, in and of itself, is not enough. Accompanying the roll-out, we wanted to ensure that there were awareness videos about how easy it is to use an AED. We want teachers, as part of their training and in the staffroom, and pupils in assemblies to see how easy an AED is to use. In a rolling way, we hoped to create a new generation of young people who are confident in their use. As AEDs become more prevalent across communities, that can only be a good thing.

I think it was the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) who asked about CPR and first aid training. As a Back Bencher, I campaigned to have first aid included on the curriculum. The Schools Minister at the time was not very happy about that—not because he was against having it on the curriculum, but because the curriculum was already very full—but we did manage to get it included. It is important that we upskill young people so they have the confidence to act in the unlikely but possible event that they encounter someone in cardiac arrest.

The question about vandalism of defibrillators is a fair one. I had not given it any thought, but I will certainly have a conversation with my counterparts in the Home Office and the Ministry of Justice and see if there is any scope to take further action in that area.

Turning to The Circuit, I would certainly like to recognise the incredibly important work that charities do in ensuring that the public have access to defibrillators. The British Heart Foundation, in partnership with Resuscitation Council UK, the Association of Ambulance Chief Executives and of course the national health service, set up The Circuit, which is the national defibrillator network database that provides information on where defibrillators are located.

I heard the point that the hon. Member for Tiverton and Honiton (Richard Foord) made about legislation, which I have some concerns about. At the moment, registration is entirely voluntary, so nobody is forced to register their defibrillator with The Circuit. However, registration enables the emergency services and community first responders to locate the nearest publicly accessible external defibrillator when they are treating someone suffering from an out-of-hospital sudden cardiac arrest. In those crucial moments after a cardiac arrest, we know that locating an AED quickly will help save lives.

[Richard Foord]

What are the arguments against making registration compulsory?

[Will Quince]

That is a question that I had not previously been asked. The danger of legislating in an area like this is that often there are consequences of legislation. One consequence would be that all existing defibrillators were registered as part of The Circuit, and that comes with a tick—that is a merit. However, having created legislation and having worked in Government Departments where legislation has been drafted on numerous occasions, I know that there are invariably and inevitably also negative unintended consequences that need to be considered and thought through.

For example, would registration discourage communities from taking a defibrillator? Would it discourage businesses like the one to which the hon. Member for Plymouth, Sutton and Devonport referred from putting one in their shop? We have to think through that kind of thing. What kind of pressure does it put on those organisations? Would it discourage people? If we are going to create legislation, what are the implications of not registering? Will there be a criminal sanction or a civil one? These are all things we would have to work through, and that is why legislating on something like this is complex. We have to remember that most defibrillators are bought by community groups, although in this particular case the Government support them. We would be placing a legal requirement on them for something that they are purchasing through goodwill, for philanthropic or altruistic reasons.

We have just got to be careful. I am not saying that we should not consider it, but it is not quite as simple as saying, “Let’s legislate,” and thinking that that will address the problem. What we need to do, and are doing, is to encourage as many people as possible to register because of the benefits of registration.

Lung Cancer Screening

Richard Foord Excerpts

Monday 26th June 2023 Commons Chamber

[Steve Barclay]

As part of expanding our capacity, we are doing both: we are expanding the diagnostic capacity—my hon. Friend is right to highlight that investment in Barnsley, as elsewhere—and boosting the surgical capacity through the expansion of our surgical hubs. In addition, we are looking at the patient pathway and identifying bottlenecks and how we design them out, given the additional capacity that is going into the system. So she is right to highlight the investment that is going in, alongside which we need to look at the patient journey and how we expedite that. The bottom line is that we are treating far more patients, the vast majority of whom—more than nine in 10—are getting treatment within a month.

[Richard Foord (Tiverton and Honiton) (LD)]

We know that 28% of victims of lung cancer have not smoked and do not smoke. My mum was one such victim. She died having contracted lung cancer and having not smoked before. But we were lucky in my family that she was diagnosed early. So, on behalf of the Liberal Democrats, I really welcome today’s announcement. However, on behalf of people in Devon whom I represent, I ask why only 40% of the people who are diagnosed will be subject to screening by 2025? Why do we have to wait until 2030 for the screening to be widespread and available to all?

[Steve Barclay]

First, may I express regret about the hon. Gentleman’s own family experience of this condition? On the roll-out programme, we need to build that capacity and to do so in a sustainable way—that point has been raised by Members across the House. We are following the science in targeting those communities that are most deprived; they have the highest prevalence of smoking. Of course we will look at evidence of other risk factors, which colleagues across the House have highlighted, but it is important that we roll this programme out in a sustainable way. What is clear, however, is that it is making progress and it is welcome that so many communities want the programme to be rolled out to their area as soon as possible.

NHS Dentists: South-West England

Richard Foord Excerpts

Wednesday 24th May 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

I am grateful to serve under your chairmanship, Ms Elliott, and to follow the hon. Member for South Dorset (Richard Drax), who made some excellent points that get to the heart of why the Government are failing us on NHS dentistry. I will follow him by using some examples and giving a voice to some of the constituents in my part of Devon who have written to me to appeal for help.

Chrissy Evans from Seaton wrote:

“I don’t understand why there has been no effort to address the problem of thousands of British children without free access to a dentist…We have tried all the dentists in our area and none are taking on new patients unless they are private.”

John Mason from Branscombe received an email advising him that his check-up was booked, only to be telephoned by the practice in Sidmouth a few weeks later. He wrote:

“I had been an NHS patient in Sidmouth for many years. I was telephoned by the practice”,

which told him that his options were to become a private patient, to try to find another dentist, or to call NHS Devon if he needed emergency treatment.

A woman from Honiton, who I do not have permission to name, has had dental issues since 2011. She wrote to me:

“I have been trying to sort this since 2011, I believe now I am considered too old to matter. I cannot eat, I don’t wish to be seen trying. I hide my face when possible. I don’t smile, I avoid friends and family, my speech is affected, this has ruined my life for the past 12 years and consumes my every thought.”

Finally, Edward Roberts from Tiverton puts it very plainly:

“The situation which prevails is unacceptable but no one in Government seems to be concerned about it.”

People are living in pain. The examples I have just given are a small snapshot of the heart-rending emails that I have received about people’s dental misery. As we have heard already, many in the west country do not have access to an NHS dentist. A survey by the British Dental Association in March laid bare the challenges we face. It found that across the south-west, nearly three in five dentists reported having reduced their NHS commitment by an average of 30%, but a staggering 75% also reported their intention to further reduce the amount of NHS work they undertake this year.

Why is this happening? Because the NHS work that dentists take on simply does not pay enough to be viable. Many NHS dentists are simply overwhelmed by the soaring costs of their work and, on this trajectory, the problem is only going to get worse. The BDA reports that 49% of south-west dentists say that they are likely to go fully private, with 41% likely to change career or seek early retirement. Fifteen per cent say that they will move abroad. Unless the Government take swift action now to start to address the situation, we could see NHS dentistry effectively disappear within a decade.

It is pretty infuriating to see the Government’s lack of recognition of the issue. Ministers at the Dispatch Box should not hide behind the outrageous claim, which I and others will have heard, that the Government have reformed the NHS contract. They have not. In July 2022, they simply paid dentists for a few more units of dental activity—for example, a dentist who is treating a mouth full of teeth that need repair will get paid the same as somebody who is treating a mouth that needs three teeth worked on. Instead, the Government should engage constructively with dentists and overhaul the NHS contract to compensate sufficiently for dental work carried out on the people who need it. Unless those steps are taken, people will continue to suffer in pain. Dentistry should not be only for those fortunate enough to win the postcode lottery.

I hope to hear from the Minister some unequivocal plans to reform the NHS dental contract, and I am curious to know what steps the Government will take to address the crumbling state of NHS dental services—I hope that they will include some measures that my Liberal Democrat colleagues and I have been calling for over many years. Above all else, I want some honesty from this Conservative Government: either reform the NHS dental contract properly, or simply admit that an NHS dental service for our constituents in the west country is a thing of the past that this Government are not willing to prioritise.

NHS Strikes

Richard Foord Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

I completely agree with my hon. Friend. Ensuring that we support the mental health and wellbeing of NHS staff and that working conditions and working environments are the best they can possibly be is how we can attract and retain the best. Measures such as wellbeing champions, training for line managers, occupational health services and flexible working are very important, but the key to this is having conversations with the unions, because they are the representatives, ambassadors and advocates. That is why I very much hope they will engage in the pay review body process and continue to have those conversations with me, not just about pay, but about how we can improve working conditions and working environments and reduce the bureaucracy that makes the job so difficult.

[Richard Foord (Tiverton and Honiton) (LD)]

It is now clearly established that the workforce crisis in the NHS is mirrored by vacancies in adult social care. There are more than 165,000 vacancies in social care, up by 52% in a year. The Liberal Democrats are calling for a carers’ minimum wage of £12.42 per hour from April; will the Minister support a £2 per hour uplift in that minimum wage for care workers by doubling the tax on the profits of online gambling companies?

[Will Quince]

The hon. Gentleman got a plug in for his policy there, but I am not entirely sure how relevant it is to this statement. On NHS staffing, we have 10,500 more nurses and 4,800 more doctors than last year. But I know adult social care represents one of the biggest challenges for our NHS, and it puts pressure on the rest of the system. That is why in the autumn statement the Chancellor put in place £7.5 billion, the largest ever investment in adult social care.