Oral Answers to Questions
Tim Farron Excerpts(2 days ago)
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Helen Whately
I commend my hon. Friend and other east Lancashire colleagues for their campaigning on this matter. I look forward to the meeting we are going to have to discuss the performance of his local A&E, and I thank him very much for the invitation to visit.
Tim Farron (Westmorland and Lonsdale) (LD)
I share an integrated care board with the hon. Member for Burnley (Antony Higginbotham) in Lancashire and South Cumbria. Does the Minister agree that one reason why there are such problems with A&E waiting times is the congestion in our hospitals overall, because of the number of people who are healthy and fit to leave hospital, but cannot have a health and care plan when they return home? Some 24% of all beds in the Morecambe Bay hospitals are occupied by people who are fit to leave, but have no care package. What plan does the Minister have to address the social care crisis in Cumbria? That will include increasing the amount of affordable housing, so that people can afford to live in the area; paying carers more; and having more intelligent visa rules.
Hospice Funding
Tim Farron Excerpts(3 days ago)
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Sally-Ann Hart
This is the point of the debate: to work out what sort of funding models we need. ICBs also need to be given the freedom to assess the priorities in their local areas, but I take that on board.
We have eight hospices across Sussex, and in 2019 seven of them formed the Sussex hospice collaborative—partnership working to ensure that the hospices’ combined resources can be used to maximise the impact, reach and cost-effectiveness of their activities. NHS Sussex works closely with that collaborative arrangement, which has supported the ability to have collective conversations. In January, the APPG on hospice and end of life care published a report on Government funding for hospices. The inquiry found that despite the introduction of a legal requirement for integrated care boards to commission palliative and end of life care, ICB commissioning of hospice services is currently not fit for purpose, and the value that hospices provide to individuals in the wider health system is at risk.
Hospice funding has historically not risen in line with inflation, which has been brought starkly to light during the periods of high inflation in recent years. Costs to keep palliative services running have increased rapidly over the past few years, but that is not reflected in the Government funding that hospices receive to deliver the services, which has increased by only 1% each year on average.
Tim Farron (Westmorland and Lonsdale) (LD)
The hon. Member is being generous, and making an outstanding speech. I congratulate her on bringing this matter to the House. St Mary’s hospice, St John’s hospice and Eden Valley hospice, which serve the communities of Westmorland, struggle like others to find the funding that they need to keep going. One issue is increased pay settlements in the NHS, which are good, but to compete, and to get and retain staff, they need to raise their pay to keep pace. Does she agree that one model may well be that, rather than devolving this to ICBs, which are not elected and not directly accountable to anybody, the Government fund through the national health service pay rises at NHS pay rates directly to all our hospices, so they at least do not have to worry about that?
Sally-Ann Hart
The hon. Gentleman raises a valuable point, which I am sure the Minister will take onboard.
Oral Answers to Questions
Tim Farron Excerpts(1 month, 3 weeks ago)
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Helen Whately
I thank my hon. Friend for his important question on concerns about the cost of care and how much it costs some people. As he may know—I remind him—the charging reforms were delayed in 2022 by the Chancellor after we listened to local authorities.
Tim Farron (Westmorland and Lonsdale) (LD)
A fifth of the social care roles in Westmorland and Furness are currently vacant and unfilled. Coincidentally that is the same proportion of beds in Morecambe Bay that are occupied by patients who are unable to get a care package and therefore leave hospital. The reasons for this are blindingly obvious: the pay and career structures are derisory for hard-working wonderful people and there is a complete absence of genuinely affordable homes for people in those sorts of roles to enable them to live locally. Does the Minister agree that fixing that crisis in my community and others should be the priority for the Chancellor tomorrow, not silly electoral gimmicks?
Helen Whately
I recognise the challenges in the hon. Gentleman’s area, although nationally vacancies in social care have fallen by over 20,000. We are reforming adult social care careers to make care a career for the UK workforce. We are putting extra funding into social care—up to £8.6 billion over two years—and introducing CQC assurance to make sure local authorities are doing their best on social care. I would encourage the hon. Gentleman to talk to his local authority and make sure it is paying a fair rate for the care it commissions.
Internationally Recruited Health and Social Care Staff: Employment Practices
Tim Farron Excerpts(2 months, 3 weeks ago)
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Tim Farron (Westmorland and Lonsdale) (LD)
It is a pleasure to serve under your guidance this afternoon, Mr Hosie, and it is great to follow the hon. Member for Strangford (Jim Shannon). The right hon. Member for Spelthorne (Kwasi Kwarteng) has made a great contribution to the House by securing this important debate and making his interesting opening speech.
The exploitation of workers, wherever they are from and whatever the circumstances, is unacceptable, and we should stand against it. Likewise, we should be deeply concerned about the state of social care in our country. The two things are clearly interlinked. The background, of which I am sure many Members will be aware, is a sharp rise in shortages in the social care workforce. That rise essentially followed from Brexit, but other issues will have led to that shrinking of the labour pool.
Perhaps understandably, the Government’s response in February 2022 was, among other things, to lower salary requirements and visa fees for migrant social care workers. That has had a significant impact on the numbers of people coming in on social care visas: there were 101,000 social care visas in 2022-23, up from 22,000 just the year before—a fourfold increase. As a result, vacancies have fallen. It does not feel like that in my part of the world, but the stats bear that out: there has been a reduction from 10.6% to 9.9% in 2023. The vacancy rate for the UK economy as a whole is 3.5%, so a bit of maths tells us that the vacancy rate in social care is getting on for three times above the national average. The increase in the number of care worker visas continues to accelerate, with 34,000 applications in quarter 3 last year.
One observation made by those who analyse the sector more scientifically—but it is my personal observation in my community as well—is that migrant workers are to a large degree replacing UK workers, who are moving to more attractive sectors. Incoming migrant workers are therefore not really filling gaps at all. Rather, they are filling additional gaps that British workers are vacating simply because care is not attractive financially or in other ways.
That highlights the big problem that is the source of all this. Social care is an utterly vital sector on which many of us depend, yet we pay a pittance to the people who lovingly and professionally care for the most vulnerable in our communities. They often have poor job security and poor working conditions, which of course impact on recruitment and retention. If this were improved, there is no doubt that we would secure more UK workers in the profession, and perhaps not put ourselves under pressure when it comes to the obvious issues of exploitation.
There was a debate in Westminster Hall this morning on hospitality and tourism. When people like me say that part of the answer is to have less restrictive visa rules for migrant labour, the Government say the answer is simply to pay British workers more. I would say to the Government, “Take your own advice.” Social care workers are paid a pittance because we underfund social care, so if the Government believe that is the way to ensure British people work in this sector, then pay them properly, and do not exploit people who come in from overseas either, because they are hugely valuable to what we are trying to achieve.
Exploitation should seriously worry us all. There are many pieces of evidence—the right hon. Member for Spelthorne set many of them out wisely and correctly—but one figure that really blew me away comes from the charity Unseen, the modern slavery and exploitation helpline. It reported a—wait for it—606% increase in the number of modern slavery cases in the care sector from 2021 to 2022. That is an absolutely astonishing increase.
As an adjunct, talking about migration policy is often emotive. Through the Government’s Illegal Migration Act 2023—it is the Act that is illegal, rather than the act of immigration—people arriving on our shores by irregular means will not have access to this country’s modern slavery provisions, unlike others. What will be the consequence? Many victims of modern slavery will not get the care they need. I also suspect that we will find that people will to our shores and simply not claim asylum, going under the radar, and that they will be exploited all the more outrageously.
Returning to the issue at hand, the director of labour market enforcement has identified adult social care as a high-risk sector for labour exploitation, with live-in and agency care workers believed to be at particular risk. Employers who are guilty of exploiting their staff are unlikely to demonstrate any better set of ethics towards the vulnerable residents who are also in their care. The increase in the salary threshold for skilled workers will not apply to those coming in on health and social care visas, yet people on those visas will, from 11 March, not be permitted to bring in dependants. That is a cruel and demoralising thing to do to people who we rely on to care for those we need the most. It is likely to lead to fewer applications, worse retention, and therefore a bigger problem for our social care sector.
In response to the vast increase in reports of exploitation of those on the health and social care visa, the Government have announced that care providers in England will be required to be regulated by the Care Quality Commission in order for them to sponsor visas. It is a good thing that care homes will have to be regulated by the CQC to sponsor migrant workers. My question for the Minister, however, is will they be required to have a minimum CQC inspection rating of good or outstanding before they are able to do so? Secondly, have any extra resources been provided to the CQC to enable them to undertake this role with the health and social care visa, given the additional effort it will involve? What powers will they have to enforce labour standards? Surely, due to the concerns raised, recruitment should only take place via agencies on the ethical recruiters list. I would be interested to hear what the Minister has to say about that.
We need to value care work, and we need to reflect that in the pay and conditions people receive. That includes treating migrant workers well. I reiterate that the decision to end their rights to have family with them is cruel and pointless, given that those people will not have recourse to public funds anyway. It is a cruel and almost performative piece of policy. It seems that the Government feel all the more inclined to give into the temptation to put silly populism and appeasing a small number of people out on the margins of the electorate ahead of governing wisely and compassionately. Whether I agree with the Government of the day or not, I always hope they will govern wisely and compassionately, yet this is another example of them failing to do that.
Labour market enforcement needs to be better resourced. It is important to establish a single enforcement body that is accessible to workers in practice and adequately funded, that is provided with robust enforcement powers, and that has secure reporting pathways. The Government must separate all labour market and immigration enforcement activity.
I have a few other thoughts about what else the Government ought to think about doing. The Health Foundation has suggested that we need to recognise that workforce planning must take account of the range of social care services and providers, as recruitment and retention can differ from place to place, and can vary considerably by care provider. For instance, places offering contract employment will find it hard to retain staff, and in some places the availability of public transport can have a massive impact on the retention of personal assistants. For those living in Cumbria, in Appleby, Ambleside or Arnside, the existence of the £2 bus fare is completely irrelevant if there ain’t no bus for them to use. That applies to people working in social care, but also to other parts of our community.
It is worthwhile getting to the very bottom of all this, which is the way we treat social care. Had we been living to the ages that we are now, when my late, great, right hon. Friend the noble Lord Beveridge wrote that important report in the 1940s, and if families had been as they are today, then I am sure social care would have been included in the national health service right from the beginning. Yet in the decades that have followed, we have attached it to the side of the health service, like a rickety lean-to. It is time we treated social care as we always should have: as integral to, and equal to, the national health service.
The situation is awful. What are the diseases we fear —those which, I guess, we fear more as we get older? Maybe the two main ones are dementia and cancer. But what a lottery: those with cancer at least get their care provided through the national health service, while those who end up with dementia are on their own and might lose absolutely everything. That is a nonsense. I want us to channel Beveridge and do what he would do today, which I am certain would be to ensure that social care workers are considered equal in value to those working in the health service, and are paid and treated accordingly.
That is why I think that free personal care is something the Government should consider seriously. I am very proud that the current Scottish Government maintain a policy that we introduced when we were in power alongside the Labour party in the ’90s and noughties. These issues are particularly relevant to communities such as mine. We are 10 years above the average age in Westmorland and Lonsdale. Our need for care is that much greater than in other parts of the country, and we value it hugely.
By the way, it is also vital that we value unpaid carers, who look after loved ones at great cost to themselves, and to whom we owe a huge debt. We should do more than just say thank you; we should change payments, benefits, and all sorts of other allowances that allow them to succeed. It was an honour for me to do the Great North Run last year, to raise funds for Carer Support South Lakes. Let us make sure we back those outfits that support our carers so well.
In conclusion, I am asking that we take the issue of exploitation seriously, that the Minister answers the questions that I and others have put to her today, and that we recognise that this is all a function of our failure to treat the labour market wisely and compassionately, and our failure to treat social care as we should. If we invested in social care properly and paid carers properly, the knock-on effect would be happier people who stayed in their positions, who were easier to recruit in the first place and who had career prospects. Those who are cared for would be happier and better cared for, and the pressure on our national health service would evaporate, or at least be alleviated, almost overnight.
In my communities in Morecambe bay and the rest of Cumbria, often more than 32% of the beds in our hospitals are occupied by people who are fit to leave, but for whom there is no care package to help them to leave. That has consequences for A&E waiting times, cancer waiting times and ambulance response times, and it is all down to the fact that no one has yet been brave and compassionate enough to tackle the care crisis meaningfully. I hope this Government will do, but if they do not, I am determined to play a part in doing just that in the next Parliament.
Oral Answers to Questions
Tim Farron Excerpts(3 months ago)
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Maria Caulfield
I thank my right hon. Friend and male colleagues on the Government Benches, including my hon. Friend the Member for Don Valley (Nick Fletcher), who are fighting so hard to improve men’s health. He is absolutely right: 12,000 men a year die from prostate cancer. That is why we are investing in the £16 million prostate cancer trial called Transform, using methods such as MRI to detect prostate cancer rather than PSA, which can be inaccurate. Thousands of men will be recruited. We are hoping that the trial will start in the spring, with recruitment in the autumn, including the recruitment of black men, who are disproportionately affected by prostate cancer.
Tim Farron (Westmorland and Lonsdale) (LD)
Does the Minister agree, however, that the information she has just given about why screening for prostate cancer does not happen for men is based on a study that is 20 years old? There are 12,000 deaths a year—it is the biggest killer among men, and the second biggest killer among all people—yet here is this evil cancer for which there is no screening programme whatsoever. Will she take steps to update current NHS guidance to ensure that all those at high risk of prostate cancer receive a targeted early detection service? I think she has hinted that she may be doing that, but will she finally introduce mass screening for prostate cancer? It is the only cancer without specifically commissioned early diagnosis work, and men are dying unnecessarily because of the failure to bring this in.
Maria Caulfield
We have more than hinted: we have just announced a £16 million pilot study of prostate cancer screening. We have a plan to tackle those 12,000 deaths a year, and it will work, because until now we have not had a diagnostic test. PSA is not a sensitive test in all prostate cancers: there are many men with prostate cancer who do not express PSA. That is why the Transform study, using detection tools such as MRI, will be trialled, and if they are effective, such tools will be rolled out across the country.
NHS Dentistry
Tim Farron Excerpts(3 months, 2 weeks ago)
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Tim Farron (Westmorland and Lonsdale) (LD)
I need hardly say that dentistry is not the only part of the national health service that the Conservative Government have allowed to fall into crisis while shamelessly seeking to shift the blame on to others. However, it is welcome that we have the chance to focus today on dentistry and on the millions of people in this country, including many thousands in Westmorland, who are being so badly let down.
For communities in Westmorland and Lonsdale, the heart of this crisis is a basic difficulty in securing an NHS appointment. Many people in our area know that they cannot afford to have their teeth or their children’s teeth checked. They feel a crushing financial burden, and a burden of guilt, because they cannot access an NHS dentist for themselves or their family, and they know that they cannot afford to go private.
This crisis has very real, very personal, very expensive and very painful consequences for people in our communities in Cumbria and nationwide. Healthwatch found that one in 10 people in England had resorted to paying for private dental care because they could not find an NHS dentist. However, most people I speak to cannot afford to go private, so what do those families do? Well, YouGov found that one in 10 adults had tried some form of DIY dentistry, the difficulty of accessing a dentist forcing them to resort to medieval practices. This country—proud of our prosperity and proud of our NHS—is in the shameful situation of its people’s teeth and, most shamefully of all, its children’s teeth, getting worse.
In 2022, the BDA found that one in four five-year-olds in my community in Cumbria had tooth decay, and that tooth decay was the No. 1 reason for hospital admissions among young people. Regular dental appointments are vital for preventing tooth decay, and even more so for children, whose teeth tend to decay more quickly. However, fewer and fewer children are able to access those appointments because of the negligence of this Government. In Cumbria, the proportion of children seen by a dentist in the NHS each year went from 64% in 2018 to just 50% last year, a drop of 14% in five years. Half of our children in our communities—from Grasmere to Grange, Appleby to Ambleside, Kendal to Kirkby Stephen and Windermere to Warcop—do not have access to an NHS dentist. That is a disgrace.
I have heard at first hand from my constituents about the shocking scale of the difficulty of getting access to appointments for children. One attendance officer at one of our primary schools wrote to me earlier last year after she found that families in her school were going abroad for dental appointments. She said:
“Tim, I felt compelled to email you to tell you… We have a high number of children who are regularly missing out on education due to being unable to register with a local NHS dentist. A large number of our children have Polish, Romanian, Latvian and Ukrainian parents and therefore will find it easier to travel back to their parents’ original home country rather than wait for a local NHS dentist who is accepting patients.”
Wow! Let us be clear: she is saying that some children in Cumbria find it easier to get dental treatment travelling to a war zone than to access the NHS dental care that their parents have already paid for through their taxes.
For adults in Cumbria, the picture is also awful. The number of adults seen by a dentist in the past two years is also down by 14%, to only 36.5%. Almost two thirds of adults in our communities in Cumbria cannot access the NHS dentists that—as I said—they have already paid for through their taxes. This is not only a crisis, but a colossal act of fraud and an injustice. People who work hard, pay their way, and rightly expect the Government to be competent enough to provide the services they have paid for are being let down, taken for a ride, and forced into either intense and painful physical suffering or paying again to get the treatment they were entitled to receive from the state. This is more than just a health issue; it is a moral issue, a fairness issue and a justice issue. A quick search of the NHS website shows that the nearest dental practice to Kendal that is taking on NHS patients is in Accrington, an 80-mile round trip, and that the nearest NHS practice to Kirkby Stephen is in Newton Aycliffe in County Durham, a round trip of two hours.
Let us remember that, as others have said, we are also facing a cancer care crisis in the UK, and part of the problem is a failure to diagnose cancers early so that they can be treated and cured. Dentists play a crucial role in identifying oral cancers, but if two thirds of Cumbria’s adults are not seeing an NHS dentist, we can be certain that cancers will be missed. They will therefore be untreatable and people will die unnecessarily. Core to our identity as Liberal Democrats is our belief that everyone in the UK should be able to access a dental health check-up on the NHS, with an emphasis on preventative oral health. We would reform the dental contract to ensure that those things take place, and fund it properly.
I am so often told by our local NHS ICB that, when all is said and done, the Government give them the money for only about half the people in our area to have access to an NHS dentist. Outrageously, that means that the only time they will contract a new NHS provider is when a previous provider has shut its doors, such as when the Avondale practice in Grange went private, leaving 5,000 people in limbo. People with a family of four faced a yearly fee of £1,000 just to stay on that practice’s books. I have proactively gone out to persuade private dentists to accept NHS work, and although I know it is only a sticking plaster, I reckon I could find more. However, the ICB will not take those dentists on because this Government will not let them. The dentistry crisis is an outrage—an injustice meted out to people and families across our area. It seems to us in Westmorland that the best way we will defeat that injustice is to defeat the Government who are responsible for it.
NHS Winter Update
Tim Farron Excerpts(3 months, 2 weeks ago)
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Victoria Atkins
My hon. Friend sets out clearly the many pressures and factors at play in running emergency departments and hospitals at the best of times, when we are not in the middle of winter and facing the pressures that it always brings on the healthcare system. I thank not only staff in his trust, but staff throughout the country for the work they have done over recent weeks to support the NHS and to bring treatment to patients. We are working hand in glove with NHSE regional and local leaders to see whether there are practical measures that can be taken to improve the flow through hospitals.
Tim Farron (Westmorland and Lonsdale) (LD)
NHS winter pressures are having a huge impact on cancer surgery and other cancer interventions. In Cumbria, in the south of the county 25% of those with a cancer diagnosis are waiting more than two months for their first intervention, and in the north of the county 47% are waiting more than two months. We know that every month’s delay in treatment means a 10% reduction in people’s chances of surviving. Some 123 cancer operations have been cancelled in the last year in our area. One reason is the lack of investment by this Government, and their predecessors of all colours, in radiotherapy. Will the Secretary of State agree to meet me and Conservative and Labour members of the all-party parliamentary group for radiotherapy, which I chair, to look at solving the problem by investing in the kit that Britain desperately needs to save lives?
Victoria Atkins
I hope the hon. Gentleman will be interested to know that we have made cancer treatment waiting times a key focus of our elective recovery plan, which has been backed by an additional £8 billion in revenue funding across the spending review period. We have made progress by delivering record numbers of urgent cancer checks, with more than 2.9 million people seen in the 12 months to October last year. Of course there is more to do, and I would be very happy to meet him and colleagues across the House to discuss the practical ways by which treatment can reach our constituents. He will not be surprised to know that cancer is a priority not just for me personally, but for the Government as a whole.
Building an NHS Fit for the Future
Tim Farron Excerpts(5 months, 2 weeks ago)
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Amy Callaghan
I would get behind a ceasefire. We are talking about a ceasefire.
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.
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.
Oral Answers to Questions
Tim Farron Excerpts(6 months, 1 week ago)
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Steve Barclay
It is always important to follow the science. That is why, at the G20, Health Ministers agreed to look at the various research being done in multiple countries, particularly on long covid but also on the lessons from that period, to ensure that research from that period is shared internationally so we can learn best practice from other countries as well as within the NHS.
Tim Farron (Westmorland and Lonsdale) (LD)
The Minister for Health and Secondary Care (Will Quince)
The Government and NHS England are committed to ensuring cancer patients can receive high quality radiotherapy treatment. Between 2016 and 2021, £162 million was invested which enabled the replacement or upgrade of around 100 radiotherapy machines. Responsibility for investment in radiotherapy machines has sat with local systems since April 2022. I look forward to meeting the hon. Gentleman and the all-party group for radiotherapy on this matter soon.
Tim Farron
I am very grateful to the Minister for his reply and in particular for the offer of the meeting coming soon. Radiotherapy UK says that for us to even meet average international standards we must commission 125 additional new linear accelerators. Will he make the commitment to do that and, in doing so, ensure that rural and remote communities do not lose out by placing some of those machines in new satellite centres, such as the Westmorland General Hospital?
Will Quince
The hon. Gentleman is hugely passionate on this subject. As I said, integrated care boards are responsible for meeting the health needs of their individual populations, and that includes capital allocation. The 2021 spending review set aside £12 billion in capital funding, and since 2016 over £160 million has been invested in radiotherapy equipment, but of course I want to see more investment in this important technology and the necessary upgrades across England. I very much look forward to our meeting, where we can discuss that further.
Countess of Chester Hospital Inquiry
Tim Farron Excerpts(7 months, 3 weeks ago)
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Steve Barclay
Again, my right hon. Friend raises an extremely important point. I am extremely keen that the families, as well as the Members of Parliament in Essex, are able to engage with the chair of the inquiry and to shape that inquiry.
As part of the discussion in Chester with families about the relative merits of a statutory or a non-statutory inquiry, one concern was that a statutory inquiry sometimes takes much longer, which is why the point around phasing is important. Of course, the court case itself will have established significant areas of factual information that can be used by the inquiry. I hope my right hon. Friend can see that the decision to put the Essex inquiry on to a statutory footing underscores our commitment to getting families the answers they need.
Tim Farron (Westmorland and Lonsdale) (LD)
My prayers remain with the families who live each day with the consequences of this unspeakable evil. Among the most chilling aspects of this tragic outrage was, as we have heard, the actions of trust leaders and managers, who ignored warnings and belittled whistleblowers. We have to ask ourselves how many lives could have been saved if people had been believed sooner.
I have to say that this feels horrifically similar to the failings in maternity services in my own local trust of Morecambe Bay during the 2000s, when we saw several mothers and babies needlessly lose their lives. Since then, despite the freedom to speak up measures that have been instituted across the country, I still see whistleblowers in other departments in trusts in the north-west marginalised, bullied, unfairly treated and having their careers trashed, all because it would appear there is a culture of defending the reputation of institutions rather than protecting the safety of patients. What confidence will the Secretary of State give to potential future whistleblowers that, when they speak out in order to save lives, they will not then be singled out?
Steve Barclay
Again, colleagues across the House know that protecting whistleblowers, including whistleblowers in the NHS, is something I have long championed. As I said earlier, the guidance has been strengthened, but one of the best mitigants is having much more transparency on the data, because the more transparent the data is, the more difficult it is for concerns to be ignored. There is a number of issues. We have strengthened the data. We have the freedom to speak up guardians. We need to look at whether, in Chester, if a freedom to speak up guardian were on the board, that would be the right approach. Do we need to look at whether these roles should be on the board? But significant work has already been done since these events and since Morecambe to strengthen the safeguards around speaking up and the Public Interest Disclosure Act. Alongside that, having organisations such as the Getting It Right First Time team looking at the neonatal data is a further important safety process to have in place.