Building an NHS Fit for the Future

Tim Farron Excerpts

Monday 13th November 2023 Commons Chamber

[Amy Callaghan]

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

[Tim Farron (Westmorland and Lonsdale) (LD)]

With both sides stopping.

[Amy Callaghan]

Yes, with both sides stopping. The hostages should be returned to Israel and we should see a ceasefire. I think that is relatively straightforward, is it not?

Finally, moving on to integrity, integrity should be the foundation of politics. Having trust that manifestos will be implemented and that policy agendas, such as the King’s Speech, will be taken through Parliament in the form of legislation is the bare minimum that folk at home expect. Instead, the British Government have thrown integrity out the window. It will be interesting to see, over the next parliamentary year, how much of what was in the King’s Speech is actually delivered.

I received a desperate appeal from the Linda Norgrove Foundation—it is named for a brave British aid worker murdered by the Taliban—for the UK Government to reopen the Afghan citizens relocation and resettlement schemes to allow 20 female Afghan medical students to come to Scotland specifically to complete their studies. It is now clear that the Taliban will never reopen schools and universities to girls. These young women are now prisoners in their own home, unable to show their face in public or to leave the house without a male guardian. Many live with the terrifying threat of forced marriage. The Linda Norgrove Foundation will pay for them to get here, and the Scottish Government have readily agreed to waive their tuition fees so that they can finish their studies. The only thing stopping these women from finding sanctuary in the UK is the British Government’s refusal to open the Afghan citizens relocation and resettlement scheme and create a legal pathway for them to do so.

That simple change would save 20 incredible women from brutal oppression at no cost to the British Government at a time when our NHS is also in desperate need of qualified doctors. I cannot think of a reason, other than performative cruelty, why the Government would withhold that permission.

I will once again say these words that are so sorely lacking down here: wisdom, justice, compassion and integrity. What could not be clearer is that Scotland’s NHS is not safe while we are tied to the financial structures of Westminster. Broken Brexit Britain is damaging our precious NHS through workforce shortages, equipment shortages and medication shortages. I look forward to a day when an independent Scotland rejoins the European Union, leaving broken Brexit Britain behind.

--- Later in debate ---

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is an honour to follow the hon. Member for Warrington South (Andy Carter). I agree with some of what he said, but I do not agree that the King’s Speech was ambitious, although it was graciously delivered and historic. A consensus is building not that there was much that was bad in the King’s Speech, but just that there was not much. For those of us who live in rural communities—knowing the challenges we face, particularly when it comes to the health service—that feels particularly hard to take.

When it comes to our health services, one issue that rural communities have in common is the distance people have to travel for care and treatment. That is particularly the case when it comes to cancer treatment. The average age of members of my community of south Cumbria and Westmorland is more than 10 years above the national average, and sadly cancer is a disease of ageing and therefore there is a greater incidence of cancer; and yet, 99% of my constituents have to travel beyond the recommended time—45 minutes maximum—to get to radiotherapy treatment at our nearest centre, the Rosemere cancer centre in Preston. That is a brilliant unit, by the way, but it is an awfully long way for people from Grasmere or Coniston, who are looking at a three-hour round trip every day to get treatment. People are often not referred for that treatment in the first place because their clinicians realise they are not able to make the journey; others do not take the treatment by personal choice or they simply do not complete treatment—and as a consequence, we see longer journeys leading to shorter lives.

There is a plan for a new radiotherapy satellite unit at the Westmorland General Hospital. I was pleased to discuss that with the hon. Member for Colchester (Will Quince) only the other day, so I am gutted that he has now left his ministerial position. On the record, I ask his successor to honour that meeting and the work we have been doing together to try to bring radiotherapy to Kendal. I worry greatly that the “building hospitals for the future” programme could move that Preston hospital, which is already too far away from our communities, even further south to South Ribble.

Hospices are also a major part of our armoury in tackling cancer and supporting those living with it. Of course, their costs have gone through the roof in recent times because of energy costs. They get only 21% of their funding from the national health service. Hospices serving our communities, such as ours in Eden Valley, St Mary’s in Ulverston and St John’s in Lancaster, have seen zero uplift to take account of the fact that their energy bills have trebled in recent times.

Let me comment on the future of Westmorland General Hospital in Kendal, which is of great importance as it is at the very heart of our community. We have seen good movement, with chemotherapy coming to our hospital after many years away, a new mental health unit, and growth in the amount of surgery that takes place there. However, we have seen the cancellation of overnight cover at Westmorland General Hospital three nights a week, meaning that people from Kendal, Burneside, Staveley and elsewhere are now expecting a doctor to come on call to them all the way from Penrith, which is a massive reduction in the quality of service and something that was promised years ago would never happen.

Let me turn to dentistry. I have intercepted a document from the chief executive of our integrated care board, berating his managers for not cutting deeply enough, at a time when, in Kendal, people’s nearest dentist—if they were trying to find an NHS one today—is in Preston. If they are in Kirkby Stephen, it is all the way over in Hexham in Northumberland. Half of all the children in my constituency have no access to an NHS dentist, and only a third of adults have that access. In Grange-over-Sands, where we lost an NHS surgery recently, a family was offered the chance to go private with the same surgery at the cost of £1,000 a year just to be registered with that practice. That is in addition to all the other cost of living challenges that that family, or any others in those communities, are facing. What is all the more appalling is that, through our taxes, these folks in my community have already paid for their NHS dentistry, yet they are being expected to pay again. Some just about pull the money together and afford to do it, but most do not and are left in staggeringly poor dental health; we also see the failure to pick up oral cancers as a consequence of people not attending the dentist.

GP surgeries are of great importance to us, as they are everywhere. In recent times, we have fought and successfully saved the Goodly Dale surgery in Bowness, the Central Lakes medical practice in Ambleside and Hawkshead, and, most recently, the practice at Haverthwaite, but the ongoing threat to our surgeries in rural communities such as mine comes from the fact that they cover vast areas, have relatively small roles and, therefore, struggle financially. I have repeatedly called on the Government to bring in a strategic small surgeries fund to make it possible for small rural GP surgeries to survive and serve their communities safely.

Over the 18 and a half years that I have served in this place, the biggest single increase in volume of casework has come from mental health issues among young people, and it is utterly and totally heartbreaking. Fifty per cent of young people on the books of child and adolescent mental health services in Cumbria and north Lancashire at the moment are those presenting with autism spectrum disorders, or attention deficit hyperactivity disorder—very often waiting two years just to be seen at all. That 50% of the workload is for those neurological conditions that do not attract any funding whatever from our local commissioners—nothing at all. Those young people are being held up in the system. They are being left to rot, as are their families and other young people, including those with eating disorders and anxiety disorders. If a 15-year-old were to break their leg on a football field on a Sunday afternoon, they would be seen within a couple of hours. If a person breaks something invisible inside them, they may wait months or even years to be treated, sometimes with fatal consequences. That is utterly and totally outrageous.

We need to tackle the subject of mental health at the beginning, so that we build resilience in young people, not just treat the symptoms. That is why I recommend the Government pick up my private Member’s Bill on outdoor education, which would compel every Government to fund every single child—once in primary school and once in secondary school—to take part in an outdoor education residential experience to build their resilience, help them to develop teamwork, and ensure that they are able to deal with the stuff that life throws at all of us at one time or another.

Finally, let me mention care. With many people above the average age in our community, it is no accident that 32% of our hospital beds were blocked early this year. Why was that? It is because there are not enough carers, and we do not pay those carers enough or treat them well enough. The consequence is the clogging up of our national health service from top to bottom—from A&E and ambulance response times to GP surgeries and everything else. Until we tackle the care crisis, we will not tackle the NHS crisis.

In a community like ours, one of the major reasons that nearly a third of the beds were blocked is the simple fact that there are not enough homes for people on average or below average incomes to live in. If we do not provide homes in communities like ours—by tackling the Airbnb crisis, the second homes crisis and the lack of social rented homes—we will have no workforce in care, in health or in any part of our public sector. Until the Government recognise the need to support those who work, and can potentially work, in health and social care, mental and physical health, we will continue to live in a crisis, particularly in rural communities like Westmorland.