NHS Workforce: England — [Mrs Madeleine Moon in the Chair]

Part of the debate – in Westminster Hall at 3:16 pm on 17th July 2019.

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Photo of Tim Farron Tim Farron Liberal Democrat Lords Spokesperson (Communities and Local Government), Liberal Democrat Spokesperson (Communities and Local Government) 3:16 pm, 17th July 2019

It is a pleasure to serve under your chairmanship, Mrs Moon. I congratulate the hon. Members for Wolverhampton South West (Eleanor Smith), for Lincoln (Karen Lee) and for St Ives (Derek Thomas) on their eloquent speeches.

The crisis in the NHS workforce is deeply concerning. Its effects are felt nationally, locally and personally. Like others here, I want to pay tribute to the people working at every level of my national health service within the south lakes: the hospital in Kendal, Westmoreland General Hospital, and the district generals that we travel to in Barrow and in Lancaster. Of course, there are the GPs, dentists, paramedics and those providing mental health services. They do an outstanding job, but it is particularly challenging in rural areas, where we have specific problems with workforce planning and supply, which are at the heart of the problems that we are challenged by.

There are several key elements to workforce planning, including accessible and high quality training, as well as affordable training, as has just been mentioned so eloquently. Effective recruitment is another. Alongside both of those is the issue of staff retention. The Secretary of State must surely be held to account for each of those. The huge shortages in the NHS workforce are felt heavily in numerous areas of healthcare provision in the local communities in Cumbria, and I briefly want to touch on a few of them.

The provision of ambulances and ambulance crews has been hit particularly hard. It is vital that we recruit and deploy more paramedics and ambulance technicians. Rural communities such as mine suffer because of the sheer distances that ambulances have to travel to reach patients. According to the review of NHS access standards, it is the responsibility of ambulance trusts to respond to category 1 calls within seven minutes on average. That is a tall order when there are half the number of ambulances per head in the north-west of England as there are in London, despite the fact that my constituency alone is bigger than the whole of Greater London. It leaves communities living in fear for their safety and takes a serious toll on the physical and mental health of our outstanding ambulance crews. Our local paramedics and ambulance technicians are being pushed beyond their capacity. As a result, I have had an influx of local people contacting me about having to wait hours for an ambulance to arrive to give them the treatment that they so desperately need. That is why local health campaigners have been calling on the Government to deliver two new fully crewed ambulances to south Lakeland to stem the crisis and ensure the safety of the community. It is not right that people in Grasmere, Dent or Hawkshead might be an hour away from the nearest available ambulance.

We met the Minister to raise the issue a few weeks ago. He was incredibly helpful and I thank him for his time and his response. I very much welcome the commitment to procure additional emergency ambulances. I understand that as a result of our campaigns an additional £8 million has been allocated to the North West Ambulance Service. That could be good news for south Cumbria, but only if the ambulance service allocates it in the way that we have asked. Ministers should be held to account for whether the ambulances materialise.

Mental health is another element of workforce planning that I want to raise—particularly provision for children. Four years ago the Government promised a bespoke one-to-one eating disorder service for young people in Cumbria. For young people in south Cumbria that promise remains nothing more than words. The specialists have not been recruited and the service still does not exist. I should love it if the Minister would tell me exactly when we can expect our young people to have access to the service. When will the promises be kept?

I welcome the Government’s commitment to preventive healthcare, set out in the NHS long-term plan. However, again, promises are not being fulfilled. In our area, cuts to the public health budget mean that the NHS in Cumbria currently spends only £75,000 a year on tier 1 mental health preventive care for children. That works out at just 75p per child per year. Proper investment in public health would ensure enough money for a mental health professional for every school and college, if we could recruit them, keeping young people mentally healthy and making sure that problems did not become so severe further down the line. It would also ease the burden on our massively oversubscribed local child and adolescent mental health services, and relieve the pressure on our brilliant but overworked teachers.

In our area, there is a problem with people moving out of NHS provision to work privately, particularly in the delivery of dental services. More than half of adults in Cumbria have not had access to an NHS dentist in the past two years, while one in three children locally does not even have a place with an NHS dentist. Much as with ambulances, the impact of the lack of a workforce of sufficient size is felt particularly acutely in rural areas. Insufficient NHS dentistry provision has resulted in families having to make ludicrously long journeys to reach the nearest surgery with an available NHS place. Often, people are unable to make those long journeys, or to afford to make them.