PARLIAMENTARY DEBATE
Health and Wellbeing Services: Essex - 12 March 2024 (Commons/Westminster Hall)
Debate Detail
Contributions from Priti Patel, are highlighted with a yellow border.
[Gordon Henderson in the Chair]
14:30:19
Priti Patel
Witham
I beg to move,
That this House has considered health and wellbeing services in Essex.
I am grateful that you are chairing the debate, Mr Henderson, and pleased to see that my right hon. Friend the Member for Pendle (Andrew Stephenson) is the Minister responding. He has been very good on many issues that I have taken to him thus far. I will cover a wide and diverse range of health-related issues affecting my constituents and people across Essex. I appreciate that some of those issues fall outside of the Minister’s portfolio, but I know he will take them on board and will feed back to colleagues. He is an excellent Minister, and I know he will respond in a helpful way. I am particularly pleased to welcome to the debate colleagues from neighbouring constituencies, my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince), because we care about the provision and quality of health and wellbeing services. It is important to our constituents, and it is important that our constituents know we will work together as neighbouring MPs on some of the issues.
As the Minister and colleagues will be aware, just over a year ago, in March 2023, we were in this very Chamber having a similar debate with a similar title—I think we stretched it to the east of England last time round—and this debate follows on from that one. Everyone here will know that Essex is an amazing county. Our residents, businesses and communities are hard-working, resilient, entrepreneurial, ambitious and aspirational. They obviously back all the Conservative values around lower taxes, being a county of entrepreneurs and the engine of economic growth. We are net contributors to the Exchequer. I never tire of saying that because, as net contributors, we in Essex do not always get our pound of flesh back from the Exchequer when it comes to investment in our public services. It is fair to say that our constituents expect that from the Exchequer, particularly the fact that we should be supported when it comes to our public services, including the NHS, but also wider health and wellbeing services that do not always require medical interventions or diagnostics.
Parts of our county—mid-Essex in particular—have experienced considerable population growth and demographic changes, and that covers the constituencies of Colchester and Maldon. For clarification, we share district boundaries, so our council boundaries are intertwined—we are effectively three integrated MPs, I think it is fair to say, on many of the issues that we stand up and speak for. Those living within Essex County Council’s boundary totalled more than 1.5 million at the 2021 census, up by more than 100,000 people on the 2011 census, which is more than 7% and above England’s average of 6.6% at the time. That includes areas such as Southend and Thurrock. When we include those areas, our county population totals just under two million, at 1.9 million. We are one of the fastest-growing counties in the country, and growth in the city of Colchester, which covers parts of my constituency, continues to grow. With that, demand on public services continues to grow. We see from the census that we have over 300,000 people aged 65 or over, which is 21% of our population. That is higher than the average in England of 18.6% and, by 2035, that number will grow by up to 27%, so just under 400,000 people in Essex. The number of those over 85 will rise by 60%, so we can see that the numbers are growing. We are an ageing not just county but country and, that impacts on the working-age population of 18 to 65-year-olds which, by contrast, is set to rise by only 4%.
We can see the counter-cyclical issues resulting from the fact that a greater part of our population will be elderly. Interestingly enough, with that ageing population we are seeing increasing numbers of young families coming to Essex, which will mean more house building. Our schools are rated good and outstanding, and we are commutable territory, so our towns are thriving and growing.
As I said in the debate last year, there are pressures on social care which have had a very significant impact on the integrated care systems that have been introduced, with further integration taking place. In particular, those pressures have had an impact on spending at the county, district and city council level. We have a number of integrated care boards that cover Essex: NHS Hertfordshire and West Essex; NHS Mid and South Essex, which predominantly covers mid-Essex; and NHS Suffolk and North East Essex, covering Colchester and Tendring.
We also have a number of hospitals, the biggest being Broomfield Hospital, Colchester Hospital, the Princess Alexandra Hospital, Basildon University Hospital and Southend University Hospital. Our emergency services are provided by the East of England Ambulance Service NHS Trust, and the South Essex Partnership NHS Foundation Trust provides mental health services. I am shortly going to discuss those areas, and those trusts in particular.
As hon. Members have heard, we have a range of trusts, hospitals and challenges in Essex. When I was first elected we had the old-fashioned primary care trusts and strategic health authorities. Those were deeply unpopular, hugely problematic and bureaucratic and massively resource-intensive, and the changes in structures we have seen now provide greater integration. What really matters to all my constituents and residents across Essex is not so much the configuration and structure of services, but how those services work together effectively to deliver what those people and their families need: primary care, appointments and access to health services.
That this House has considered health and wellbeing services in Essex.
I am grateful that you are chairing the debate, Mr Henderson, and pleased to see that my right hon. Friend the Member for Pendle (Andrew Stephenson) is the Minister responding. He has been very good on many issues that I have taken to him thus far. I will cover a wide and diverse range of health-related issues affecting my constituents and people across Essex. I appreciate that some of those issues fall outside of the Minister’s portfolio, but I know he will take them on board and will feed back to colleagues. He is an excellent Minister, and I know he will respond in a helpful way. I am particularly pleased to welcome to the debate colleagues from neighbouring constituencies, my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince), because we care about the provision and quality of health and wellbeing services. It is important to our constituents, and it is important that our constituents know we will work together as neighbouring MPs on some of the issues.
As the Minister and colleagues will be aware, just over a year ago, in March 2023, we were in this very Chamber having a similar debate with a similar title—I think we stretched it to the east of England last time round—and this debate follows on from that one. Everyone here will know that Essex is an amazing county. Our residents, businesses and communities are hard-working, resilient, entrepreneurial, ambitious and aspirational. They obviously back all the Conservative values around lower taxes, being a county of entrepreneurs and the engine of economic growth. We are net contributors to the Exchequer. I never tire of saying that because, as net contributors, we in Essex do not always get our pound of flesh back from the Exchequer when it comes to investment in our public services. It is fair to say that our constituents expect that from the Exchequer, particularly the fact that we should be supported when it comes to our public services, including the NHS, but also wider health and wellbeing services that do not always require medical interventions or diagnostics.
Parts of our county—mid-Essex in particular—have experienced considerable population growth and demographic changes, and that covers the constituencies of Colchester and Maldon. For clarification, we share district boundaries, so our council boundaries are intertwined—we are effectively three integrated MPs, I think it is fair to say, on many of the issues that we stand up and speak for. Those living within Essex County Council’s boundary totalled more than 1.5 million at the 2021 census, up by more than 100,000 people on the 2011 census, which is more than 7% and above England’s average of 6.6% at the time. That includes areas such as Southend and Thurrock. When we include those areas, our county population totals just under two million, at 1.9 million. We are one of the fastest-growing counties in the country, and growth in the city of Colchester, which covers parts of my constituency, continues to grow. With that, demand on public services continues to grow. We see from the census that we have over 300,000 people aged 65 or over, which is 21% of our population. That is higher than the average in England of 18.6% and, by 2035, that number will grow by up to 27%, so just under 400,000 people in Essex. The number of those over 85 will rise by 60%, so we can see that the numbers are growing. We are an ageing not just county but country and, that impacts on the working-age population of 18 to 65-year-olds which, by contrast, is set to rise by only 4%.
We can see the counter-cyclical issues resulting from the fact that a greater part of our population will be elderly. Interestingly enough, with that ageing population we are seeing increasing numbers of young families coming to Essex, which will mean more house building. Our schools are rated good and outstanding, and we are commutable territory, so our towns are thriving and growing.
As I said in the debate last year, there are pressures on social care which have had a very significant impact on the integrated care systems that have been introduced, with further integration taking place. In particular, those pressures have had an impact on spending at the county, district and city council level. We have a number of integrated care boards that cover Essex: NHS Hertfordshire and West Essex; NHS Mid and South Essex, which predominantly covers mid-Essex; and NHS Suffolk and North East Essex, covering Colchester and Tendring.
We also have a number of hospitals, the biggest being Broomfield Hospital, Colchester Hospital, the Princess Alexandra Hospital, Basildon University Hospital and Southend University Hospital. Our emergency services are provided by the East of England Ambulance Service NHS Trust, and the South Essex Partnership NHS Foundation Trust provides mental health services. I am shortly going to discuss those areas, and those trusts in particular.
As hon. Members have heard, we have a range of trusts, hospitals and challenges in Essex. When I was first elected we had the old-fashioned primary care trusts and strategic health authorities. Those were deeply unpopular, hugely problematic and bureaucratic and massively resource-intensive, and the changes in structures we have seen now provide greater integration. What really matters to all my constituents and residents across Essex is not so much the configuration and structure of services, but how those services work together effectively to deliver what those people and their families need: primary care, appointments and access to health services.
14:37:30
Jim Shannon
Strangford
I commend the right hon. Lady on the debate. It is clearly about health services in Essex, and is therefore not to do with Strangford. However, to add my support to what the right hon. Lady is saying, I note that the problems in Essex she has outlined are replicated across my constituency as well. They include the closure of the local minor injuries unit, which is integral to the local community. That means that constituents have to travel further to get their healthcare—the very thing that the right hon. Lady is referring to. Does she agree that health bodies must focus more on community health and wellbeing to ensure that all constituents have the local access they deserve to efficient health and care services? Again, I commend the right hon. Lady on introducing the debate.
14:37:56
Priti Patel
The hon. Gentleman is absolutely right, and he has teed up the issue I wanted to raise—community healthcare provision and localised services. I have just mentioned our big hospitals in Essex, but it is absolutely vital that we have localised healthcare provision.
That brings me on to a local issue that affects my right hon. Friend the Member for Maldon and me—the future of St Peter’s Hospital. I raised this issue in the House last week in Health questions, and my right hon. Friend the Member for Maldon has secured an Adjournment debate on Thursday to discuss it further. Last night I attended a public meeting hosted and organised in Witham by Witham Town Council on this matter.
I know that colleagues will say more about this issue later in this debate, but for context, to say that my right hon. Friend and I are receiving hefty mailbags on this issue would be an understatement. We are receiving unprecedented levels of correspondence and communication —emails and phone calls—from concerned and angry residents who are frustrated by the plans put forward by the integrated care board to remove services from St Peter’s hospital, which could lead to its closure under the proposed consultation. The Minister will know that the plans are subject to consultation; my right hon. Friend and I have called for it to be extended, and yesterday we were given confirmation that it has been.
The measures that we are discussing include the removal of stroke rehabilitation in-patient beds to Brentwood and Rochford, which are not local areas and require considerable travel, and making permanent the temporary removal of a midwife-led birthing unit. The ICB is also seeking views on the future removal of other services from the site, including out-patient services covering blood tests, ultrasound scans, X-rays, podiatry clinics and services to support mental health patients, with an average total of around 300 patients a day using the particular site.
I should add that this is a much-loved community site, and it is fair to say that across the generations everyone in our district would have had some kind of interaction or engagement with it. I myself have used St Peter’s and its maternity facilities. Last night, I met some of its maternity nurses, who kindly came to our public debate. They are remarkable ladies, who are wonderful in the care and compassion that they give to mothers, particularly new mothers who, quite frankly, struggle after the birth of their first child to adapt to some of the post-maternity services. The nurses are wonderful.
The hospital serves the town of Maldon and the wider rural area, including people in Maldon district who live in the Witham constituency. This part of Essex has experienced very considerable economic growth, particularly housing growth. My right hon. Friend the Member for Maldon cannot speak about small housing developments—we have significant housing developments in our constituencies. I will refer to the Westcombe Park development in Heybridge, which straddles both our constituencies. It is a development of over 1,000 homes, which speaks to the type of developments that we have locally. The current local plan runs up to 2029, and we will see the development of another 5,000 homes in that time. I recognise that we need more homes—people need homes to live in and we aspire to own our homes—but we also need to know that new housing and population growth will attract the infrastructure and public services to support them in the long run.
The consultation about St Peter’s is very important. The document covers a range of issues, but I have to say that it is not acceptable for us to say, “It’s fine for the services to go elsewhere and be relocated.” Our constituents would experience considerable travel times if services were relocated and there are issues with local public transport as well. I am afraid to say that trying to park a car at Broomfield Hospital is nigh-on impossible. We want to those services to remain local; that is absolutely pivotal. Importantly, they should remain within Maldon town and Maldon district.
Our constituents have serious reservations about these proposals and it is right that we, as local MPs, continue to support, champion and work with the integrated care board, and work with local authorities, Ministers and the Government to secure these services in Maldon town. We have to keep these services in our district. I know that the Minister cannot specifically intervene in matters being considered by the ICB, but I would welcome his views, and I think this issue is going to be very important going forward. This consultation also sets a benchmark for engagement with ICBs and future-proofing localised healthcare services, which we all want to see in our constituencies.
I have mentioned the need to enhance services and safeguard them in Maldon and Maldon district. The Department is very familiar with communication around Witham town and my calls over 14 years for a new health centre there. My correspondence file in the Department is large; I know that, and I thank Ministers for their forbearance and all the responses that they have sent to me. However, like Maldon, Witham has experienced huge amounts of housing growth, which means that the demand for primary care is outstripping supply.
We have four GP practices in the town and I will name them all: Fern House surgery has 16,500 patients; Douglas Grove surgery has 6,500 patients; Witham practice has 6,500 patients; and Collingwood Road practice, which I visited recently, has 2,500 patients. That is a total patient list of about 32,000 just in the town itself. The national patient to GP ratio average is around 1,700 patients per GP, but across those four surgeries there are around 13 full-time equivalent GPs, which means that the local patient to GP ratio is closer to 2,500. That is the tense situation that we have and the challenge that we face.
We also have the incredible Anglia Ruskin University medical facility. Many of us were part of the group making the business case that was made for that and we are very proud of it. In September 2023, we saw the first cohort of medical practitioners from that facility. We are desperate to make sure that we keep them all local; we absolutely want them to remain local.
However, we need to discuss the practicalities and how hard it is to get a GP appointment. That is why we need new facilities, more support for GPs and more primary care staff to improve health services in Witham. I am consistent in my campaigning for all of that.
I pay tribute to Braintree District Council, which has been on this journey with us. We have capital funding for a service, but the Minister will recognise that we need the GP practices to make the business case on how they can work together. I pay tribute also to the work of the local ICB and the NHS Alliance director for mid-Essex, Dan Doherty, who has undertaken to pursue this project with local councillors. For the first time in a decade, I feel that we have better collaboration and a stronger commitment to making this happen.
We have opportunities to redevelop locations. I cannot speak about them because some are commercially sensitive and are subject to the local councils and the ICB working together. We need the critical mass of our GPs to commit firmly to driving this proposal forward. The Minister knows that it cannot be achieved without them. We want to ensure that there is sustainability and a future business for them. For example, we are protecting prescribing, because one of the practices is a prescribing pharmacy. It is important that we give them the approach to do this.
With the game-changing dialogue that we hear in Government about localised health services, community pharmacies, and my right hon. Friend the Chancellor’s focus on improving efficiency in the NHS, if we can knit those strands together, this could develop and lead to great outcomes for Witham town. The frustration of my constituents in Witham town is palpable; they have been waiting decades for this. We as a Government must deliver for them, and I will continue to press the Government on this.
In addition to the growing demands in Witham, we have growing demand for primary care and GP services in other parts of my constituency. These are theoretically villages but their growth means they are not analogous with the old view of what a village looks like; they include Kelvedon and Feering. Stanway in its own right is no longer a village; it has become a town within the Colchester city footprint. The beautiful village of Tiptree is famous for Wilkin & Sons and some other wonderful businesses. The Tiptree medical centre now has 12,000 patients on its books, and there are concerns that that is too many for one practice to handle. I recently received a letter from the practice explaining that their clinical rooms are full to capacity, and that they may consider options to close their patient list to new patients, formally or informally, and to reduce their patient catchment area significantly, so as not to include patients who are registered in the CM postcode area.
That is worrying and deeply concerning. Action is needed to address concerns about the impact of population growth. That is something our local authorities should be doing as they develop their local plans—they have to be much more strategic. Six years ago, a very unpopular planning application was submitted for 200 dwellings in Tiptree. It was widely opposed, including on the basis of pressures on the local health services, the Tiptree medical practice in particular. Initially the application put aside land for a new medical facility; despite local opposition, the application was granted on appeal, but in the end no site for a medical facility was included, according to the decision issued. That said that the application originally included the provision of land for a medical facility but that that was removed from the proposal because Tiptree medical centre and North East Essex clinical commissioning group no longer required the land on the site, and instead requested a financial contribution towards the provision of medical facilities. That contribution has been incorporated into the section 106 agreement. As we can see from the correspondence I referred to from the medical practice, the new capacity is now not sufficient.
What we now have in Tiptree is an unwelcome development: a growing population but no significant new investment to meet the demands. Again, across Essex, planning contributions to health facilities are inadequate. They are not delivering on the improvements that have been promised, and that is totally unsustainable. I would like the Minister and the Department to review this and, in particular, look into the provision of GP services in Tiptree, and with the CCG look at how developer contributions are secured and issued.
As well as protecting and enhancing primary care facilities, we need to talk about GP training. I have already mentioned the facility at Anglia Ruskin University, which we are thrilled to have. I think that the Minister himself may have recently visited, and I will be heading there this week as well. It is an incredible facility that we need to grow at some stage, which I am already hinting to the Minister basically means expansion. We can then grow its capacity and have more locally trained medical practitioners.
On the subject of healthcare in our community, I thank the Minister and the Government for empowering pharmacies to deliver more services, which was long overdue. I have raised that issue in previous debates and I spoke about it when we had the announcement in January that pharmacies can now support patients with seven common conditions. That reportedly frees up something like an incredible 10 million GP appointments a year, while providing pharmacies with new business activities that importantly keep their footfall going.
Our local pharmacies are at the heart of our communities. That is pivotal, which is particularly in constituencies like mine and that that of my right hon. Friend the Member for Maldon, which as hon. Members will know, touch the coast. I urge the Minister to consider empowering pharmacies by giving them the opportunity to grow that provision around the wider conditions that they can treat. I am a great believer in social prescribing as well, and some of those pharmacies could even utilise their own buildings as social prescribing hubs, which we should all collectively look to expand.
The Minister has heard me touch on the importance of investment in primary care services, but the statistics I referenced in my opening remarks demonstrate the importance of prevention and social care services. I have to say that Essex County Council is blessed with the high-calibre leadership of Councillor Kevin Bentley and Councillor John Spence, who is the portfolio holder for health, adult social care and integrated care systems integration, and it has a strong record in supporting investment and service area improvements. I do not say that lightly because we were not there a decade ago, when none of us wanted to use the infamous term “bed-blocking” or say that it would take place in our hospitals, the implications of which we all know.
At any one time, the council is supporting around 16,000 people with social care, and 40,000 during the course of the year. Over 90% of people who use its services say that they are safe and secure, and the council is supporting increasing numbers with hospital discharges and reablement services. I visited an organisation called Medequip on Friday, based in Braintree district, that is contracted by Essex County Council. The innovation and the quality of care and equipment that it is providing for reablement services is phenomenal, and we really have to do much more to support that. For example, the Essex Wellbeing Service has helped 73% of people in Essex to quit smoking, which is an important intervention using preventative care, and it also supported the provision of 42,000 NHS health checks. We need to do much more on health checks, particularly cancer checks.
I will not repeat the numbers on the elderly population, but the population with learning disabilities and autism is also increasing. It is expected to grow by 3% by 2025—just next year—and the population of working-age adults with sensory impairments will grow by 5%. The council is spending around £500,000 a year on adult social care services, just over £200 million on people aged over 65 and just under £300 million on working age adults between 18 and 64. I welcome the funding that we have, but we definitely need much more.
I met parents yesterday in my constituency who are fighting for education, health and care plans—a common experience for all of us now. Since 2019, under Essex County Council, the number of EHCPs has increased from just under 9,000 to over 11,600 in 2023—a 29% increase in four years. Essex is doing very well at this compared with many authorities, but we are struggling to get these plans for children. That is a long-standing issue. The Minister will recognise that we are seeing greater demand from parents and that schools are raising this issue.
Another area of frontline health provision that will be familiar to the Minister is dentistry. In the east of England in particular—not just Essex—we have long-standing problems. The Library has shown that, in 2023, around 52.2% of children in Essex had seen a dentist in the past two years, which is just under the English average of 53%. Our figures are not good, and I would like to hear from the Minister how we are going to make progress in this area.
I thank the Minister for the time he gave us last week to discuss the mental health statutory inquiry. Colleagues in Essex are familiar with the concerns about this issue. When we debated health and wellbeing services last year, the inquiry was on a non-statutory footing. It was established back in 2021 to investigate 2,000 in-patient deaths that had occurred since 2000. I pay tribute to Geraldine Strathdee for her work in chairing that inquiry and for doing all she could to gather evidence and see the witnesses that participated in that work. She, families and colleagues in this place were frustrated that not enough progress was being made and, importantly, that not enough evidence was coming forward. Colleagues pressed for the inquiry to be converted to a statutory inquiry, and we now have Baroness Kate Lampard chairing it. Over the past few months, she has been consulting on the terms of reference. I thank Kate for the work that she is doing. Obviously, the Minister is familiar with this. We are waiting for the terms of reference to be finalised.
Our constituents have been incredible in their dignity, their courage and their bravery but also in their resilience. As human beings, they have been through a terrible ordeal—they really have. They want to see the statutory inquiry progress at pace. I pay tribute to my constituent Melanie Leahy, whose son Matthew died in 2012 while a patient in the Linden centre. My right hon. Friend the Member for Maldon will speak to this as well, as Melanie Leahy was at one stage his constituent. She is remarkable for the way in which she tackled what I call the institutional state failure of her son’s treatment. Importantly, she helped to get a statutory inquiry. The families must all get the answers that they need and see lessons learned from what happened. We owe it to those who lost their lives and to their families to change the system and to get answers. I look forward to the Minister’s comments on this in particular and on how we will come together to make time to meet the families and to work with them.
My final comments speak to the future of the NHS—the workforce plan, the growing demand for services and work on recruitment. I spoke about this in my last dialogue with the chief executive of Broomfield Hospital. I am interested in this, and I ask questions all the time. The House has heard the numbers and the statistics I put forward on how difficult it is to get an appointment and how pressed we are in terms of medical practitioners.
We should also recognise that we have an incredible international workforce locally. Our NHS would be in a much more difficult position if it was not for the staff from Botswana, India, Pakistan, Nigeria, Nepal, Sudan, India and Egypt who are working in our health and social care services and contributing to our public services, our economy and our tax system. They care for elderly and vulnerable residents across our constituencies, and they should be thanked for that.
There have been interesting debates on migration, immigration and on the skills and contributions of those coming to our country. Of course there is a need to control numbers, but we have to recognise that we rely on those skills and contributions because of workforce pressures and the fact that we have not done enough as an economy and a country to grow skillsets here. I encourage the Minister to ensure that, as part of the NHS long-term workforce plan, we do much more. We have Anglia Ruskin University and other universities across the country, but we must do more.
I want the Government to recognise that we need a wider labour market strategy that addresses these issues, which sometimes unnecessarily inflame debates around immigration. They must also recognise that many of those who come to our country through a skilled worker route pay thousands of pounds in immigration health surcharges, which contributes to the finances of the NHS. Many of them are also higher-rate taxpayers and contribute to our economy, our country and important sectors.
Of course, technology also has a role to play—it really does. We can do so much more using technology, and we must make sure that we absolutely grow the workforce locally going forward.
I have presented the Minister with a long list of health and wellbeing issues across Essex, and I thank him and his team for their patience—he is a great Minister, who is very considered, and I know he will respond accordingly. With investment, innovation and support, our health and wellbeing services across Essex could be so much better. Importantly, they could meet the needs of our constituents and ensure that we have not just a sustainable NHS service that meets the needs of our population, but a happier and healthier population.
That brings me on to a local issue that affects my right hon. Friend the Member for Maldon and me—the future of St Peter’s Hospital. I raised this issue in the House last week in Health questions, and my right hon. Friend the Member for Maldon has secured an Adjournment debate on Thursday to discuss it further. Last night I attended a public meeting hosted and organised in Witham by Witham Town Council on this matter.
I know that colleagues will say more about this issue later in this debate, but for context, to say that my right hon. Friend and I are receiving hefty mailbags on this issue would be an understatement. We are receiving unprecedented levels of correspondence and communication —emails and phone calls—from concerned and angry residents who are frustrated by the plans put forward by the integrated care board to remove services from St Peter’s hospital, which could lead to its closure under the proposed consultation. The Minister will know that the plans are subject to consultation; my right hon. Friend and I have called for it to be extended, and yesterday we were given confirmation that it has been.
The measures that we are discussing include the removal of stroke rehabilitation in-patient beds to Brentwood and Rochford, which are not local areas and require considerable travel, and making permanent the temporary removal of a midwife-led birthing unit. The ICB is also seeking views on the future removal of other services from the site, including out-patient services covering blood tests, ultrasound scans, X-rays, podiatry clinics and services to support mental health patients, with an average total of around 300 patients a day using the particular site.
I should add that this is a much-loved community site, and it is fair to say that across the generations everyone in our district would have had some kind of interaction or engagement with it. I myself have used St Peter’s and its maternity facilities. Last night, I met some of its maternity nurses, who kindly came to our public debate. They are remarkable ladies, who are wonderful in the care and compassion that they give to mothers, particularly new mothers who, quite frankly, struggle after the birth of their first child to adapt to some of the post-maternity services. The nurses are wonderful.
The hospital serves the town of Maldon and the wider rural area, including people in Maldon district who live in the Witham constituency. This part of Essex has experienced very considerable economic growth, particularly housing growth. My right hon. Friend the Member for Maldon cannot speak about small housing developments—we have significant housing developments in our constituencies. I will refer to the Westcombe Park development in Heybridge, which straddles both our constituencies. It is a development of over 1,000 homes, which speaks to the type of developments that we have locally. The current local plan runs up to 2029, and we will see the development of another 5,000 homes in that time. I recognise that we need more homes—people need homes to live in and we aspire to own our homes—but we also need to know that new housing and population growth will attract the infrastructure and public services to support them in the long run.
The consultation about St Peter’s is very important. The document covers a range of issues, but I have to say that it is not acceptable for us to say, “It’s fine for the services to go elsewhere and be relocated.” Our constituents would experience considerable travel times if services were relocated and there are issues with local public transport as well. I am afraid to say that trying to park a car at Broomfield Hospital is nigh-on impossible. We want to those services to remain local; that is absolutely pivotal. Importantly, they should remain within Maldon town and Maldon district.
Our constituents have serious reservations about these proposals and it is right that we, as local MPs, continue to support, champion and work with the integrated care board, and work with local authorities, Ministers and the Government to secure these services in Maldon town. We have to keep these services in our district. I know that the Minister cannot specifically intervene in matters being considered by the ICB, but I would welcome his views, and I think this issue is going to be very important going forward. This consultation also sets a benchmark for engagement with ICBs and future-proofing localised healthcare services, which we all want to see in our constituencies.
I have mentioned the need to enhance services and safeguard them in Maldon and Maldon district. The Department is very familiar with communication around Witham town and my calls over 14 years for a new health centre there. My correspondence file in the Department is large; I know that, and I thank Ministers for their forbearance and all the responses that they have sent to me. However, like Maldon, Witham has experienced huge amounts of housing growth, which means that the demand for primary care is outstripping supply.
We have four GP practices in the town and I will name them all: Fern House surgery has 16,500 patients; Douglas Grove surgery has 6,500 patients; Witham practice has 6,500 patients; and Collingwood Road practice, which I visited recently, has 2,500 patients. That is a total patient list of about 32,000 just in the town itself. The national patient to GP ratio average is around 1,700 patients per GP, but across those four surgeries there are around 13 full-time equivalent GPs, which means that the local patient to GP ratio is closer to 2,500. That is the tense situation that we have and the challenge that we face.
We also have the incredible Anglia Ruskin University medical facility. Many of us were part of the group making the business case that was made for that and we are very proud of it. In September 2023, we saw the first cohort of medical practitioners from that facility. We are desperate to make sure that we keep them all local; we absolutely want them to remain local.
However, we need to discuss the practicalities and how hard it is to get a GP appointment. That is why we need new facilities, more support for GPs and more primary care staff to improve health services in Witham. I am consistent in my campaigning for all of that.
I pay tribute to Braintree District Council, which has been on this journey with us. We have capital funding for a service, but the Minister will recognise that we need the GP practices to make the business case on how they can work together. I pay tribute also to the work of the local ICB and the NHS Alliance director for mid-Essex, Dan Doherty, who has undertaken to pursue this project with local councillors. For the first time in a decade, I feel that we have better collaboration and a stronger commitment to making this happen.
We have opportunities to redevelop locations. I cannot speak about them because some are commercially sensitive and are subject to the local councils and the ICB working together. We need the critical mass of our GPs to commit firmly to driving this proposal forward. The Minister knows that it cannot be achieved without them. We want to ensure that there is sustainability and a future business for them. For example, we are protecting prescribing, because one of the practices is a prescribing pharmacy. It is important that we give them the approach to do this.
With the game-changing dialogue that we hear in Government about localised health services, community pharmacies, and my right hon. Friend the Chancellor’s focus on improving efficiency in the NHS, if we can knit those strands together, this could develop and lead to great outcomes for Witham town. The frustration of my constituents in Witham town is palpable; they have been waiting decades for this. We as a Government must deliver for them, and I will continue to press the Government on this.
In addition to the growing demands in Witham, we have growing demand for primary care and GP services in other parts of my constituency. These are theoretically villages but their growth means they are not analogous with the old view of what a village looks like; they include Kelvedon and Feering. Stanway in its own right is no longer a village; it has become a town within the Colchester city footprint. The beautiful village of Tiptree is famous for Wilkin & Sons and some other wonderful businesses. The Tiptree medical centre now has 12,000 patients on its books, and there are concerns that that is too many for one practice to handle. I recently received a letter from the practice explaining that their clinical rooms are full to capacity, and that they may consider options to close their patient list to new patients, formally or informally, and to reduce their patient catchment area significantly, so as not to include patients who are registered in the CM postcode area.
That is worrying and deeply concerning. Action is needed to address concerns about the impact of population growth. That is something our local authorities should be doing as they develop their local plans—they have to be much more strategic. Six years ago, a very unpopular planning application was submitted for 200 dwellings in Tiptree. It was widely opposed, including on the basis of pressures on the local health services, the Tiptree medical practice in particular. Initially the application put aside land for a new medical facility; despite local opposition, the application was granted on appeal, but in the end no site for a medical facility was included, according to the decision issued. That said that the application originally included the provision of land for a medical facility but that that was removed from the proposal because Tiptree medical centre and North East Essex clinical commissioning group no longer required the land on the site, and instead requested a financial contribution towards the provision of medical facilities. That contribution has been incorporated into the section 106 agreement. As we can see from the correspondence I referred to from the medical practice, the new capacity is now not sufficient.
What we now have in Tiptree is an unwelcome development: a growing population but no significant new investment to meet the demands. Again, across Essex, planning contributions to health facilities are inadequate. They are not delivering on the improvements that have been promised, and that is totally unsustainable. I would like the Minister and the Department to review this and, in particular, look into the provision of GP services in Tiptree, and with the CCG look at how developer contributions are secured and issued.
As well as protecting and enhancing primary care facilities, we need to talk about GP training. I have already mentioned the facility at Anglia Ruskin University, which we are thrilled to have. I think that the Minister himself may have recently visited, and I will be heading there this week as well. It is an incredible facility that we need to grow at some stage, which I am already hinting to the Minister basically means expansion. We can then grow its capacity and have more locally trained medical practitioners.
On the subject of healthcare in our community, I thank the Minister and the Government for empowering pharmacies to deliver more services, which was long overdue. I have raised that issue in previous debates and I spoke about it when we had the announcement in January that pharmacies can now support patients with seven common conditions. That reportedly frees up something like an incredible 10 million GP appointments a year, while providing pharmacies with new business activities that importantly keep their footfall going.
Our local pharmacies are at the heart of our communities. That is pivotal, which is particularly in constituencies like mine and that that of my right hon. Friend the Member for Maldon, which as hon. Members will know, touch the coast. I urge the Minister to consider empowering pharmacies by giving them the opportunity to grow that provision around the wider conditions that they can treat. I am a great believer in social prescribing as well, and some of those pharmacies could even utilise their own buildings as social prescribing hubs, which we should all collectively look to expand.
The Minister has heard me touch on the importance of investment in primary care services, but the statistics I referenced in my opening remarks demonstrate the importance of prevention and social care services. I have to say that Essex County Council is blessed with the high-calibre leadership of Councillor Kevin Bentley and Councillor John Spence, who is the portfolio holder for health, adult social care and integrated care systems integration, and it has a strong record in supporting investment and service area improvements. I do not say that lightly because we were not there a decade ago, when none of us wanted to use the infamous term “bed-blocking” or say that it would take place in our hospitals, the implications of which we all know.
At any one time, the council is supporting around 16,000 people with social care, and 40,000 during the course of the year. Over 90% of people who use its services say that they are safe and secure, and the council is supporting increasing numbers with hospital discharges and reablement services. I visited an organisation called Medequip on Friday, based in Braintree district, that is contracted by Essex County Council. The innovation and the quality of care and equipment that it is providing for reablement services is phenomenal, and we really have to do much more to support that. For example, the Essex Wellbeing Service has helped 73% of people in Essex to quit smoking, which is an important intervention using preventative care, and it also supported the provision of 42,000 NHS health checks. We need to do much more on health checks, particularly cancer checks.
I will not repeat the numbers on the elderly population, but the population with learning disabilities and autism is also increasing. It is expected to grow by 3% by 2025—just next year—and the population of working-age adults with sensory impairments will grow by 5%. The council is spending around £500,000 a year on adult social care services, just over £200 million on people aged over 65 and just under £300 million on working age adults between 18 and 64. I welcome the funding that we have, but we definitely need much more.
I met parents yesterday in my constituency who are fighting for education, health and care plans—a common experience for all of us now. Since 2019, under Essex County Council, the number of EHCPs has increased from just under 9,000 to over 11,600 in 2023—a 29% increase in four years. Essex is doing very well at this compared with many authorities, but we are struggling to get these plans for children. That is a long-standing issue. The Minister will recognise that we are seeing greater demand from parents and that schools are raising this issue.
Another area of frontline health provision that will be familiar to the Minister is dentistry. In the east of England in particular—not just Essex—we have long-standing problems. The Library has shown that, in 2023, around 52.2% of children in Essex had seen a dentist in the past two years, which is just under the English average of 53%. Our figures are not good, and I would like to hear from the Minister how we are going to make progress in this area.
I thank the Minister for the time he gave us last week to discuss the mental health statutory inquiry. Colleagues in Essex are familiar with the concerns about this issue. When we debated health and wellbeing services last year, the inquiry was on a non-statutory footing. It was established back in 2021 to investigate 2,000 in-patient deaths that had occurred since 2000. I pay tribute to Geraldine Strathdee for her work in chairing that inquiry and for doing all she could to gather evidence and see the witnesses that participated in that work. She, families and colleagues in this place were frustrated that not enough progress was being made and, importantly, that not enough evidence was coming forward. Colleagues pressed for the inquiry to be converted to a statutory inquiry, and we now have Baroness Kate Lampard chairing it. Over the past few months, she has been consulting on the terms of reference. I thank Kate for the work that she is doing. Obviously, the Minister is familiar with this. We are waiting for the terms of reference to be finalised.
Our constituents have been incredible in their dignity, their courage and their bravery but also in their resilience. As human beings, they have been through a terrible ordeal—they really have. They want to see the statutory inquiry progress at pace. I pay tribute to my constituent Melanie Leahy, whose son Matthew died in 2012 while a patient in the Linden centre. My right hon. Friend the Member for Maldon will speak to this as well, as Melanie Leahy was at one stage his constituent. She is remarkable for the way in which she tackled what I call the institutional state failure of her son’s treatment. Importantly, she helped to get a statutory inquiry. The families must all get the answers that they need and see lessons learned from what happened. We owe it to those who lost their lives and to their families to change the system and to get answers. I look forward to the Minister’s comments on this in particular and on how we will come together to make time to meet the families and to work with them.
My final comments speak to the future of the NHS—the workforce plan, the growing demand for services and work on recruitment. I spoke about this in my last dialogue with the chief executive of Broomfield Hospital. I am interested in this, and I ask questions all the time. The House has heard the numbers and the statistics I put forward on how difficult it is to get an appointment and how pressed we are in terms of medical practitioners.
We should also recognise that we have an incredible international workforce locally. Our NHS would be in a much more difficult position if it was not for the staff from Botswana, India, Pakistan, Nigeria, Nepal, Sudan, India and Egypt who are working in our health and social care services and contributing to our public services, our economy and our tax system. They care for elderly and vulnerable residents across our constituencies, and they should be thanked for that.
There have been interesting debates on migration, immigration and on the skills and contributions of those coming to our country. Of course there is a need to control numbers, but we have to recognise that we rely on those skills and contributions because of workforce pressures and the fact that we have not done enough as an economy and a country to grow skillsets here. I encourage the Minister to ensure that, as part of the NHS long-term workforce plan, we do much more. We have Anglia Ruskin University and other universities across the country, but we must do more.
I want the Government to recognise that we need a wider labour market strategy that addresses these issues, which sometimes unnecessarily inflame debates around immigration. They must also recognise that many of those who come to our country through a skilled worker route pay thousands of pounds in immigration health surcharges, which contributes to the finances of the NHS. Many of them are also higher-rate taxpayers and contribute to our economy, our country and important sectors.
Of course, technology also has a role to play—it really does. We can do so much more using technology, and we must make sure that we absolutely grow the workforce locally going forward.
I have presented the Minister with a long list of health and wellbeing issues across Essex, and I thank him and his team for their patience—he is a great Minister, who is very considered, and I know he will respond accordingly. With investment, innovation and support, our health and wellbeing services across Essex could be so much better. Importantly, they could meet the needs of our constituents and ensure that we have not just a sustainable NHS service that meets the needs of our population, but a happier and healthier population.
15:01:35
Will Quince
Colchester
It is a pleasure to serve under your chairmanship, Mr Henderson. I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing this important debate on health and wellbeing services in Essex. Her powerful speech raised a number of issues affecting all parts of Essex, including my own, in north Essex, and specifically Colchester. Understandably, I plan to focus on north Essex and my constituency, but given that I stood down as a Minister of State at the Department of Health and Social Care only in late November, I want to start with some reflections on our NHS more generally. May I say in passing that the Minister is doing a marvellous job with a difficult brief? As he knows, it is a privilege and an honour to be a Minister at the Department of Health and Social Care and to be part of our NHS’s story.
The NHS is a universal, comprehensive system that is free at the point of use and paid for through taxation—principles that remain intact and that receive strong public and political support today. At its heart, as my right hon. Friend the Member for Witham set out, the NHS is not about buildings and equipment—as important as those are, and we are of course passionate about health centres, hospitals and the latest technology—but about the circa 2 million people who work in it day in, day out to deliver and facilitate the high-quality care we rightly expect. I want to take this opportunity to thank everyone who works in our NHS, especially those working in north Essex and those serving patients and my constituents in Colchester.
We all have our personal experiences of our NHS and of the care that we and our families have received. When we think about the future of health and wellbeing services in Essex, we have to be mindful of the broader context, much of which my right hon. Friend set out in her powerful speech. Our NHS is under significant and considerable pressure and faces a number of challenges. We have increasing demand, particularly in primary care and in urgent and emergency care. We are living longer, which is brilliant, but it comes with challenges, including living with complex conditions and comorbidities.
Social care continues to be a challenge, especially around workforce, as my right hon. Friend set out. We have increasing demand on mental health services. We had the covid pandemic, with the backlog and the waiting lists, but also the resulting later diagnosis of cardiovascular disease and other conditions, as many people were unable to or did not come forward with symptoms or for regular check-ups.
We also have the at times seemingly intractable complexity of NHS structures and processes; the silo mentality that we sadly see so often; the multiple tiers and archaic processes; the challenges in rolling out the latest innovative technologies, such as tech, drugs, treatment and therapies, that are available in some parts of Essex or the country but not in others; and the issue of making sure that research and innovation is truly embedded in every single trust in the country.
That is not an exhaustive list, and I have not mentioned two of the biggest challenges—workforce and funding—one of which my right hon. Friend touched on in some detail. First, on funding, the NHS will always need increased funding to reflect the changing nature of medicine and the health needs of our population and, importantly, to ensure that we have the very latest and most innovative and cutting-edge medtech, treatments, drugs, procedures and therapies for our patients. Despite record revenue and capital budgets for our NHS, year-on-year real-terms increases in funding, and further significant funding—in fact, several billion pounds of funding—announced in the spring Budget, which I massively welcome, budgets remain a challenge for local systems and for trusts, not just in Essex but across the country.
Secondly, as my right hon. Friend pointed out, workforce is absolutely vital to our NHS, and she was right to mention the hugely important contribution that international staff make—they have contributed since its formation, and continue to do so. Regardless of the NHS long-term workforce plan, as important as it is, international recruitment will still have a hugely important role to play.
I was a Minister at the DHSC when the Government commissioned NHS England to produce the first ever NHS long-term workforce plan, which the Minister will no doubt elaborate on. The plan was then published, backed with £2.4 billion over the next five years by the Government. It included things like doubling medical school places, including at Anglia Ruskin University, which we are incredibly proud of; huge increases in nursing, midwifery and allied health professional training places; and a plan for retention—it is critical that it is about not just recruitment but retention and, of course, reform.
We talk about workforce and funding, but the truth is that addressing those two things alone will not tackle the challenges our NHS faces either nationally or locally. Only by innovating and transforming local systems and the delivery of health and care provision at a local level can we deliver on what we all aspire to across this House, which is our local populations living longer, healthier, happier and more fulfilling lives.
I firmly believe that integrated care systems, which my right hon. Friend touched on, are at the heart of achieving that. They are working holistically at a local level to get systems focusing relentlessly on patient outcomes and patient experiences, and breaking down the silo mentality that we have sadly so often seen in our NHS historically. Their other critical role is driving transformation and innovation at a local level, getting trusts and organisations to work together, and using all assets and capacity within health systems.
I pay tribute, as my right hon. Friend did, to the leadership of the Suffolk & North East Essex Integrated Care System—Dr Ed Garratt and his team. I know how closely they work with Nick Hulme and his team at the East Suffolk and North Essex NHS Foundation Trust or, as it is known locally, Colchester and Ipswich Hospitals. Our health system more broadly, and our two acute hospital trusts in north Essex and east Suffolk, face many of the challenges I set out earlier, but to their great credit, they are continuously looking at innovative ways to address them.
For example, our system in north Essex and east Suffolk is consistently one the highest and best-performing in the country. It had the fastest roll-out of the covid-19 vaccine. It is a top performer for diabetes care. It has consistently low levels of delayed discharge, an issue my right hon. Friend the Minister and his fellow Minister, the Minister for Social Care, spent a lot of time focusing on, and rightly so, because of the continued pressure on urgent and emergency care and the importance of tackling delayed discharge.
Our local system has also led on innovation. It has developed the Care Tech Campus and the challenge fund, in particular, with the University of Essex and Essex County Council. My right hon. Friend the Member for Witham was right to praise the role that Councillors Kevin Bentley and John Spence have played in that, working in partnership with the health system to deliver innovation in care that is providing not just better outcomes, but a better experience for patients. Finally, our local system is leading the way on National Institute for Health and Care Research-funded research, which we want more trusts across the country to do.
Before I finish, I want to raise a handful of initiatives in north Essex and east Suffolk that I think deserve highlighting, because they are going to be transformational in terms of both patient experience and outcome. The first is the elective orthopaedic centre at Colchester Hospital, which I was fortunate enough to have a tour of recently. It is hugely exciting. It is an impressive £64 million facility serving north-east Essex and east Suffolk. It is the largest of its kind in Europe, at over 11,000 square metres, and will include eight theatres, three wards, a physio, a gym, a day surgery, a recovery centre and its own imaging department. Importantly—I know the Minister will be pleased to hear this—it will enable 10,000 procedures a year following its opening, which is due to take place this August.
The second initiative is the Clacton community diagnostic centre, in the constituency of my hon. Friend the Member for Clacton (Giles Watling). I am sorry he could not be here for the debate, but I want to reference it as it serves the wider area. The centre is a £25 million investment in state-of-the-art diagnostics, meaning that patients can access the full range of diagnostic services, including CT scans, MRI scans, X-rays, ultrasounds, blood scans and cardiorespiratory medicine. Importantly—I visited a lot of community diagnostic centres when I was in the Minister’s role—this facility has delivered more than 110,000 treatments in the past year. I would love it if the Minister could check this, but I think that it must be one of the highest performing centres—if not the highest performing centre—in the country.
I want to turn now to two mental health and mental resilience projects, which our integrated care system is leading on and which I think deserve a mention. The first is the north-east Essex mental health joint response vehicle, which was successfully commissioned as a three-year service following a successful pilot between January and March 2023. This unique service is a collaboration between the East of England Ambulance Service and the Essex Partnership University NHS Foundation Trust—our mental health trust—with a paramedic and mental health practitioner manning a 10-hour service seven days a week. That service has been so successful in ensuring that those experiencing a mental health crisis are seen by the most appropriate service. I am really keen that we extend those hours, and I know that the ICS is looking at securing additional funding to do so.
The data backs up why it is a good thing to do. In 2023, the joint response vehicle attended 757 patient calls for a variety of mental health-related presentations, including suicidal threat, self-harm, depression and psychosis, with 77% of patients being redirected to another service or provided with a care plan at home, reducing by 55% the number of attendances at emergency departments for mental health-related issues. I will not need to remind the Minister that mental health is not only one of the largest drivers of attendance at our emergency departments, especially involving conveyance via ambulance, but leads to some of the longest cubicle occupation in our emergency departments, as hospitals do not have the beds to move people up and into, and often takes up additional resource, such as police officers and others.
The second initiative I want to touch on involves primary school wellbeing hubs—these are more about mental resilience, but I think that that is an important area to highlight. When I was Schools Minister and Children’s Minister, we worked closely with the Department of Health and Social Care on investment in mental health resilience support with mental health support teams, on training for schools and on the support teams that would go into schools to provide that support.
The Tendring and Colchester wellbeing hubs are a pilot project with 22 primary schools in Colchester and Tendring, which aims to improve children’s mental health and wellbeing through a prevention and early intervention approach. This programme has delivered across 22 schools, with 19 of them completing a number of questionnaires that have been evaluated by the University of Essex to demonstrate the impact and evaluate the programme over the 12 months in which it has run.
Overall, pupils who attended the wellbeing hub sessions had significant increases in their levels of resilience, wellbeing and happiness and decreased anxiety. The initiative was supported by more than 80% of parents, who said that their children communicated better, while more than 60% of children said they had more confidence and were more resilient and less stressed or anxious. I know that such programmes are happening to varying degrees across the country, but our integrated care system is really leading the way and demonstrating things that could be replicated and rolled out to other parts of the country.
In conclusion, I thank again all those involved in the delivery of healthcare across north Essex, as well as the leadership of the Suffolk & North East Essex Integrated Care System and the East Suffolk and North Essex NHS Foundation Trust for driving the innovation and transformation of health and care provision locally. We know that that is the future of delivering not just better a patient experience, but better patient outcomes. I once again thank my right hon. Friend the Member for Witham for giving us the opportunity to talk about health and wellbeing services in Essex, which, as she rightly said, we all care so passionately about. We all know that the challenges both locally and nationally are significant, and we all want and expect world-class care for our constituents. I know that I and all my Essex colleagues will continue to work with our local NHS bodies in all their guises to support them to deliver it.
The NHS is a universal, comprehensive system that is free at the point of use and paid for through taxation—principles that remain intact and that receive strong public and political support today. At its heart, as my right hon. Friend the Member for Witham set out, the NHS is not about buildings and equipment—as important as those are, and we are of course passionate about health centres, hospitals and the latest technology—but about the circa 2 million people who work in it day in, day out to deliver and facilitate the high-quality care we rightly expect. I want to take this opportunity to thank everyone who works in our NHS, especially those working in north Essex and those serving patients and my constituents in Colchester.
We all have our personal experiences of our NHS and of the care that we and our families have received. When we think about the future of health and wellbeing services in Essex, we have to be mindful of the broader context, much of which my right hon. Friend set out in her powerful speech. Our NHS is under significant and considerable pressure and faces a number of challenges. We have increasing demand, particularly in primary care and in urgent and emergency care. We are living longer, which is brilliant, but it comes with challenges, including living with complex conditions and comorbidities.
Social care continues to be a challenge, especially around workforce, as my right hon. Friend set out. We have increasing demand on mental health services. We had the covid pandemic, with the backlog and the waiting lists, but also the resulting later diagnosis of cardiovascular disease and other conditions, as many people were unable to or did not come forward with symptoms or for regular check-ups.
We also have the at times seemingly intractable complexity of NHS structures and processes; the silo mentality that we sadly see so often; the multiple tiers and archaic processes; the challenges in rolling out the latest innovative technologies, such as tech, drugs, treatment and therapies, that are available in some parts of Essex or the country but not in others; and the issue of making sure that research and innovation is truly embedded in every single trust in the country.
That is not an exhaustive list, and I have not mentioned two of the biggest challenges—workforce and funding—one of which my right hon. Friend touched on in some detail. First, on funding, the NHS will always need increased funding to reflect the changing nature of medicine and the health needs of our population and, importantly, to ensure that we have the very latest and most innovative and cutting-edge medtech, treatments, drugs, procedures and therapies for our patients. Despite record revenue and capital budgets for our NHS, year-on-year real-terms increases in funding, and further significant funding—in fact, several billion pounds of funding—announced in the spring Budget, which I massively welcome, budgets remain a challenge for local systems and for trusts, not just in Essex but across the country.
Secondly, as my right hon. Friend pointed out, workforce is absolutely vital to our NHS, and she was right to mention the hugely important contribution that international staff make—they have contributed since its formation, and continue to do so. Regardless of the NHS long-term workforce plan, as important as it is, international recruitment will still have a hugely important role to play.
I was a Minister at the DHSC when the Government commissioned NHS England to produce the first ever NHS long-term workforce plan, which the Minister will no doubt elaborate on. The plan was then published, backed with £2.4 billion over the next five years by the Government. It included things like doubling medical school places, including at Anglia Ruskin University, which we are incredibly proud of; huge increases in nursing, midwifery and allied health professional training places; and a plan for retention—it is critical that it is about not just recruitment but retention and, of course, reform.
We talk about workforce and funding, but the truth is that addressing those two things alone will not tackle the challenges our NHS faces either nationally or locally. Only by innovating and transforming local systems and the delivery of health and care provision at a local level can we deliver on what we all aspire to across this House, which is our local populations living longer, healthier, happier and more fulfilling lives.
I firmly believe that integrated care systems, which my right hon. Friend touched on, are at the heart of achieving that. They are working holistically at a local level to get systems focusing relentlessly on patient outcomes and patient experiences, and breaking down the silo mentality that we have sadly so often seen in our NHS historically. Their other critical role is driving transformation and innovation at a local level, getting trusts and organisations to work together, and using all assets and capacity within health systems.
I pay tribute, as my right hon. Friend did, to the leadership of the Suffolk & North East Essex Integrated Care System—Dr Ed Garratt and his team. I know how closely they work with Nick Hulme and his team at the East Suffolk and North Essex NHS Foundation Trust or, as it is known locally, Colchester and Ipswich Hospitals. Our health system more broadly, and our two acute hospital trusts in north Essex and east Suffolk, face many of the challenges I set out earlier, but to their great credit, they are continuously looking at innovative ways to address them.
For example, our system in north Essex and east Suffolk is consistently one the highest and best-performing in the country. It had the fastest roll-out of the covid-19 vaccine. It is a top performer for diabetes care. It has consistently low levels of delayed discharge, an issue my right hon. Friend the Minister and his fellow Minister, the Minister for Social Care, spent a lot of time focusing on, and rightly so, because of the continued pressure on urgent and emergency care and the importance of tackling delayed discharge.
Our local system has also led on innovation. It has developed the Care Tech Campus and the challenge fund, in particular, with the University of Essex and Essex County Council. My right hon. Friend the Member for Witham was right to praise the role that Councillors Kevin Bentley and John Spence have played in that, working in partnership with the health system to deliver innovation in care that is providing not just better outcomes, but a better experience for patients. Finally, our local system is leading the way on National Institute for Health and Care Research-funded research, which we want more trusts across the country to do.
Before I finish, I want to raise a handful of initiatives in north Essex and east Suffolk that I think deserve highlighting, because they are going to be transformational in terms of both patient experience and outcome. The first is the elective orthopaedic centre at Colchester Hospital, which I was fortunate enough to have a tour of recently. It is hugely exciting. It is an impressive £64 million facility serving north-east Essex and east Suffolk. It is the largest of its kind in Europe, at over 11,000 square metres, and will include eight theatres, three wards, a physio, a gym, a day surgery, a recovery centre and its own imaging department. Importantly—I know the Minister will be pleased to hear this—it will enable 10,000 procedures a year following its opening, which is due to take place this August.
The second initiative is the Clacton community diagnostic centre, in the constituency of my hon. Friend the Member for Clacton (Giles Watling). I am sorry he could not be here for the debate, but I want to reference it as it serves the wider area. The centre is a £25 million investment in state-of-the-art diagnostics, meaning that patients can access the full range of diagnostic services, including CT scans, MRI scans, X-rays, ultrasounds, blood scans and cardiorespiratory medicine. Importantly—I visited a lot of community diagnostic centres when I was in the Minister’s role—this facility has delivered more than 110,000 treatments in the past year. I would love it if the Minister could check this, but I think that it must be one of the highest performing centres—if not the highest performing centre—in the country.
I want to turn now to two mental health and mental resilience projects, which our integrated care system is leading on and which I think deserve a mention. The first is the north-east Essex mental health joint response vehicle, which was successfully commissioned as a three-year service following a successful pilot between January and March 2023. This unique service is a collaboration between the East of England Ambulance Service and the Essex Partnership University NHS Foundation Trust—our mental health trust—with a paramedic and mental health practitioner manning a 10-hour service seven days a week. That service has been so successful in ensuring that those experiencing a mental health crisis are seen by the most appropriate service. I am really keen that we extend those hours, and I know that the ICS is looking at securing additional funding to do so.
The data backs up why it is a good thing to do. In 2023, the joint response vehicle attended 757 patient calls for a variety of mental health-related presentations, including suicidal threat, self-harm, depression and psychosis, with 77% of patients being redirected to another service or provided with a care plan at home, reducing by 55% the number of attendances at emergency departments for mental health-related issues. I will not need to remind the Minister that mental health is not only one of the largest drivers of attendance at our emergency departments, especially involving conveyance via ambulance, but leads to some of the longest cubicle occupation in our emergency departments, as hospitals do not have the beds to move people up and into, and often takes up additional resource, such as police officers and others.
The second initiative I want to touch on involves primary school wellbeing hubs—these are more about mental resilience, but I think that that is an important area to highlight. When I was Schools Minister and Children’s Minister, we worked closely with the Department of Health and Social Care on investment in mental health resilience support with mental health support teams, on training for schools and on the support teams that would go into schools to provide that support.
The Tendring and Colchester wellbeing hubs are a pilot project with 22 primary schools in Colchester and Tendring, which aims to improve children’s mental health and wellbeing through a prevention and early intervention approach. This programme has delivered across 22 schools, with 19 of them completing a number of questionnaires that have been evaluated by the University of Essex to demonstrate the impact and evaluate the programme over the 12 months in which it has run.
Overall, pupils who attended the wellbeing hub sessions had significant increases in their levels of resilience, wellbeing and happiness and decreased anxiety. The initiative was supported by more than 80% of parents, who said that their children communicated better, while more than 60% of children said they had more confidence and were more resilient and less stressed or anxious. I know that such programmes are happening to varying degrees across the country, but our integrated care system is really leading the way and demonstrating things that could be replicated and rolled out to other parts of the country.
In conclusion, I thank again all those involved in the delivery of healthcare across north Essex, as well as the leadership of the Suffolk & North East Essex Integrated Care System and the East Suffolk and North Essex NHS Foundation Trust for driving the innovation and transformation of health and care provision locally. We know that that is the future of delivering not just better a patient experience, but better patient outcomes. I once again thank my right hon. Friend the Member for Witham for giving us the opportunity to talk about health and wellbeing services in Essex, which, as she rightly said, we all care so passionately about. We all know that the challenges both locally and nationally are significant, and we all want and expect world-class care for our constituents. I know that I and all my Essex colleagues will continue to work with our local NHS bodies in all their guises to support them to deliver it.
15:16:19
Sir John Whittingdale
Maldon
I thank my right hon. Friend the Member for Witham (Priti Patel) for obtaining this debate. As she said, we who represent the county of Essex work together closely on these matters, and I absolutely endorse everything that she and my hon. Friend the Member for Colchester (Will Quince) said.
I was elected originally for a constituency called South Colchester and Maldon, which included the areas in the Maldon district now represented by my right hon. Friend the Member for Witham and a number of wards in the Colchester constituency. During all the time that I have represented the area, we have been debating the problems of healthcare in the county, particularly the lack of funding.
When I first came to this place, we were part of something called the North East Thames regional health authority. My right hon. Friend is right that the record of NHS funding overall has been very good, but we have suffered consistently from a skew, with more money going originally to the areas of London that were part of the North East Thames RHA, and subsequently, through the various allocation formulas, we have lost out. The funding per head has been consistently below what is needed, and that is reflected in some of the problems we have, particularly because, at the same time that we have been underfunded, we have seen steady and continuing population growth. My right hon. Friend referred to the 1,000-plus houses being built in Heybridge, part of which falls in my constituency. I have another development on the other side of Maldon from Heybridge of another 1,500 houses. About 3,000 houses are going up in Maldon and Heybridge alone, with more houses across the district. They are putting steadily increasing pressure on the health service.
The issue of St Peter’s Hospital, to which my right hon. Friend referred, is of huge importance to the town’s residents, the Maldon district and the surrounding area. I will bring that matter to the House’s attention on Thursday in an Adjournment debate, when we will have a lot more to say about it. However, it is fair to say, in summary, that St Peter’s Hospital is 150 years old, it has been steadily deteriorating and, in all the time that I have represented the area, we have been debating a replacement. We have come very close a number of times, but each time it has never quite happened. It has now reached the point where the hospital can no longer safely provide services in some of the areas, because the original structure is not appropriate, and although money has been spent on it, the hospital has nevertheless deteriorated. We have been debating whether to refurbish or relocate it for all these years, but nothing happened until we reached the point where it is now proposed that the hospital is closed and services—particularly maternity and in-patient services—are moved to other locations far from my constituency and, particularly, some of the more remote areas. I will speak about that in more detail on Thursday, but it is an indicator of the way in which my part of Essex, particularly, has been under-provided for for far too long.
That is also reflected in the access to primary care, which my right hon. Friend mentioned. We have two GP practices in Maldon. They both have patient lists well in excess of 12,000. I know that across the country people struggle to get appointments. We all hear about the difficulty that people have—they ring at five-past 8 and are told that the appointments are all gone—but it is especially acute in Maldon. Both those practices are in buildings that are simply not fit for purpose, and that compounds the problem. In each case, we are looking to reap a benefit from this housing development by obtaining investment into infrastructure.
I share my right hon. Friend’s view that those currently trying to supply health services across the county are doing their best. I join her in congratulating and thanking the leadership of Essex County Council, whom I met last week to discuss these problems, including Kevin Bentley and his colleagues. Equally, I thank the representatives of the ICB, but we have reached a point where action has to be taken, and we are looking to the Government for help. As I say, I will talk more about that on Thursday. I know that every MP will claim that their area needs more support, but our situation is the consequence of decades of underfunding. We have been shouting loudly for too long without being heard, and we have reached a point where something has to change.
My right hon. Friend mentioned the Essex mental health inquiry, now called the Lampard inquiry. Melanie Leahy, originally my constituent but now a constituent of my right hon. Friend, and my constituent Lisa Morris have been calling attention to and ringing alarm bells about what has been going on in mental healthcare in Essex for a long time. When they first started doing so, they asked for an inquiry. For a long time they were denied it, until eventually we recognised that, clearly, something was badly wrong. The number of deaths that happened under the care of the then mental health trust was excessive and needed examination.
The Government eventually agreed and set up an inquiry, but it was not statutory. My constituents came back and said that it has to be statutory. At the time, we said to them that we had discussed this with the then Ministers, who said, “No, but our advantage is in it not being statutory. Therefore, we should not go down that road.” The Government have now accepted that the inquiry does have to be made statutory, and at last a proper examination can take place to identify exactly what has been going on. Concerns are still being expressed by campaigners who have lost family members.
I welcome the meeting that I had with my right hon. Friends, including the Minister, just a week ago to discuss how to proceed with the inquiry. There are real concerns over the timescale, which is being examined, and whether the inquiry can continue to examine deaths that are still taking place. Even very recently, there was a death.
Equally, there is concern that the lawyers, Hodge Jones & Allen, have been working pro bono on this, and they need some kind of remuneration if they are to continue. In other inquiries, lawyers representing family members have received interim payments, and the lawyers in this case also need some support, so I ask the Minister to consider that. Most importantly, however, they have been promised meetings. I know that the Minister is in the process of setting those meetings up, including with the Secretary of State so that she can hear directly from some of the families who have been affected. I know that the Minister is also looking at the terms of reference and the process under which the inquiry proceeds.
This has been going on a very long time. The Minister will understand the frustration, so we would be grateful to hear anything from him this afternoon about whether we can now press ahead and have those meetings with the families and those representing them, and get a proper, full examination of what has happened in the Essex Partnership University NHS Foundation Trust and its predecessor bodies.
I will return some of those themes on Thursday. Again, I thank my right hon. Friend the Member for Witham; we will continue to work together with my hon. Friend the Member for Colchester (Will Quince), and across the county, to ensure that our constituents receive the proper healthcare that they deserve.
I was elected originally for a constituency called South Colchester and Maldon, which included the areas in the Maldon district now represented by my right hon. Friend the Member for Witham and a number of wards in the Colchester constituency. During all the time that I have represented the area, we have been debating the problems of healthcare in the county, particularly the lack of funding.
When I first came to this place, we were part of something called the North East Thames regional health authority. My right hon. Friend is right that the record of NHS funding overall has been very good, but we have suffered consistently from a skew, with more money going originally to the areas of London that were part of the North East Thames RHA, and subsequently, through the various allocation formulas, we have lost out. The funding per head has been consistently below what is needed, and that is reflected in some of the problems we have, particularly because, at the same time that we have been underfunded, we have seen steady and continuing population growth. My right hon. Friend referred to the 1,000-plus houses being built in Heybridge, part of which falls in my constituency. I have another development on the other side of Maldon from Heybridge of another 1,500 houses. About 3,000 houses are going up in Maldon and Heybridge alone, with more houses across the district. They are putting steadily increasing pressure on the health service.
The issue of St Peter’s Hospital, to which my right hon. Friend referred, is of huge importance to the town’s residents, the Maldon district and the surrounding area. I will bring that matter to the House’s attention on Thursday in an Adjournment debate, when we will have a lot more to say about it. However, it is fair to say, in summary, that St Peter’s Hospital is 150 years old, it has been steadily deteriorating and, in all the time that I have represented the area, we have been debating a replacement. We have come very close a number of times, but each time it has never quite happened. It has now reached the point where the hospital can no longer safely provide services in some of the areas, because the original structure is not appropriate, and although money has been spent on it, the hospital has nevertheless deteriorated. We have been debating whether to refurbish or relocate it for all these years, but nothing happened until we reached the point where it is now proposed that the hospital is closed and services—particularly maternity and in-patient services—are moved to other locations far from my constituency and, particularly, some of the more remote areas. I will speak about that in more detail on Thursday, but it is an indicator of the way in which my part of Essex, particularly, has been under-provided for for far too long.
That is also reflected in the access to primary care, which my right hon. Friend mentioned. We have two GP practices in Maldon. They both have patient lists well in excess of 12,000. I know that across the country people struggle to get appointments. We all hear about the difficulty that people have—they ring at five-past 8 and are told that the appointments are all gone—but it is especially acute in Maldon. Both those practices are in buildings that are simply not fit for purpose, and that compounds the problem. In each case, we are looking to reap a benefit from this housing development by obtaining investment into infrastructure.
I share my right hon. Friend’s view that those currently trying to supply health services across the county are doing their best. I join her in congratulating and thanking the leadership of Essex County Council, whom I met last week to discuss these problems, including Kevin Bentley and his colleagues. Equally, I thank the representatives of the ICB, but we have reached a point where action has to be taken, and we are looking to the Government for help. As I say, I will talk more about that on Thursday. I know that every MP will claim that their area needs more support, but our situation is the consequence of decades of underfunding. We have been shouting loudly for too long without being heard, and we have reached a point where something has to change.
My right hon. Friend mentioned the Essex mental health inquiry, now called the Lampard inquiry. Melanie Leahy, originally my constituent but now a constituent of my right hon. Friend, and my constituent Lisa Morris have been calling attention to and ringing alarm bells about what has been going on in mental healthcare in Essex for a long time. When they first started doing so, they asked for an inquiry. For a long time they were denied it, until eventually we recognised that, clearly, something was badly wrong. The number of deaths that happened under the care of the then mental health trust was excessive and needed examination.
The Government eventually agreed and set up an inquiry, but it was not statutory. My constituents came back and said that it has to be statutory. At the time, we said to them that we had discussed this with the then Ministers, who said, “No, but our advantage is in it not being statutory. Therefore, we should not go down that road.” The Government have now accepted that the inquiry does have to be made statutory, and at last a proper examination can take place to identify exactly what has been going on. Concerns are still being expressed by campaigners who have lost family members.
I welcome the meeting that I had with my right hon. Friends, including the Minister, just a week ago to discuss how to proceed with the inquiry. There are real concerns over the timescale, which is being examined, and whether the inquiry can continue to examine deaths that are still taking place. Even very recently, there was a death.
Equally, there is concern that the lawyers, Hodge Jones & Allen, have been working pro bono on this, and they need some kind of remuneration if they are to continue. In other inquiries, lawyers representing family members have received interim payments, and the lawyers in this case also need some support, so I ask the Minister to consider that. Most importantly, however, they have been promised meetings. I know that the Minister is in the process of setting those meetings up, including with the Secretary of State so that she can hear directly from some of the families who have been affected. I know that the Minister is also looking at the terms of reference and the process under which the inquiry proceeds.
This has been going on a very long time. The Minister will understand the frustration, so we would be grateful to hear anything from him this afternoon about whether we can now press ahead and have those meetings with the families and those representing them, and get a proper, full examination of what has happened in the Essex Partnership University NHS Foundation Trust and its predecessor bodies.
I will return some of those themes on Thursday. Again, I thank my right hon. Friend the Member for Witham; we will continue to work together with my hon. Friend the Member for Colchester (Will Quince), and across the county, to ensure that our constituents receive the proper healthcare that they deserve.
Abena Oppong-Asare
Erith and Thamesmead
It is a pleasure to serve under your chairmanship, Mr Henderson. I thank the right hon. Member for Witham (Priti Patel) for securing this important debate; I know this is something she is passionate about. She highlighted a number of important issues and concerns regarding health and wellbeing services in her constituency and across Essex, and I am pleased to respond on the Opposition’s behalf. I also thank other hon. Members for their contributions to the debate; I have found it very insightful.
I will start with GPs, as securing the future of general practice is integral to the future of the NHS as a whole. GPs are vital to their communities and contribute hugely to keeping the nation healthy. However, the Government have broken their promise to recruit more than 6,000 GPs in the last five years. Ultimately, the NHS has lost the equivalent of 1,830 full-time, fully qualified GPs since 2015. There is a GP shortage crisis, and Essex is unfortunately on its frontline.
When we break down the numbers of patients per GP in the UK, Mid and South Essex ICB is worse than anywhere else in the country—I do not dispute that. There is one GP for every 2,281 patients. Staff shortages are a vicious cycle that leads to worsening outcomes, and we must train thousands more GPs to finally end that cycle. If we do not, we risk allowing the health of our nation, and the health of the people of Essex, to just get worse.
It is also worrying that the Care Quality Commission warned Mid and South Essex NHS Foundation Trust last summer over failings in three Essex hospitals. It found that medical care had deteriorated, with waiting times not meeting national standards and patients not accessing services when they needed them. The people of Essex deserve better care. They deserve to be seen on time, and to have local hospitals providing quality care for them when they need it most.
In recent years, elective waiting lists have risen sharply in every region and area of England. However, there are large geographical differences, with the east of England being one of worst affected areas. When we compare the figures with January 2020, the waiting list at the end of last year was 113% higher in the east of England. At the start of last year, the Prime Minister made a promise to the country to get NHS waiting lists down. Last month, he admitted the obvious—that he had failed. However, the reality is that the Government have failed in achieving most of the waiting list and waiting time targets since 2010. Unfortunately, that is a result of 14 years of successive Conservative Governments running the NHS.
I will quickly reflect on the worrying state of maternal health services in Essex. We face a crisis in maternity services across the country, with the CQC rating two out of three maternity units dangerously substandard. For the people of Essex, all but one maternity hospital unit is failing. Following the release of the final Ockenden report nearly two years ago, I urge the Minister to respond on the Government’s progress on implementing the report’s immediate and essential actions in trusts across the country. Safe care for women, babies and their families must be the top priority for our Government. It is clear that more needs to be done to improve care and safety in maternity services in England.
The Essex mental health inquiry has been covered in this debate, and I praise the grieving families and hard-working campaigners for their efforts in securing a statutory inquiry. In particular, I want to honour Melanie Leahy, whose son Matthew died more than 10 years ago in a mental health unit in Essex. She has never given up hope of getting justice and fighting to improve mental health provision in Essex and across the country, and she is an inspiration to us all.
Labour welcomed the announcement at that time, and I hope to hear an update from the Government today about progress on the Lampard inquiry. The Secretary of State offered to meet families last year, but that has yet to happen. The Guardian reported today that bereaved families have accused the Minister of dragging their feet over the inquiry into the death of almost 2,000 patients across NHS mental health trusts in Essex. I hope to hear from him about when that meeting is scheduled to take place and when the inquiry’s terms of reference are scheduled to be published.
I urge the Government to do all they can to ensure that the inquiry finally provides answers for the bereaved families, who have been waiting for far too long. While we are most determined to find answers to the specific inquiry, we must be clear that poor mental health services and standards are worryingly prevalent across other parts of the country. We continue to hear of other tragedies in mental health services; those are unacceptable. The Government must treat those incidences as a wake-up call and act in the light of the soaring number of investigations to prevent any further suffering or loss of life.
In recent years, one of the ways the Government could have acted would have been to deliver a reformed mental health Act. Reforms would have finally modernised legislation to strengthen people’s rights and choices within mental health settings. That was a manifesto pledge by the Government, and the Bill is ready to go—“oven-ready” as some on the Government Benches might have said previously. There is no excuse for the delay, but the Government have failed to get it done and deliver those much-needed changes. Labour has committed to introducing such a Bill in our first King’s Speech. Not only will it deliver real change to mental health services across the country, but it will deliver 8,500 new mental health specialists, mental health support in every school and open-access mental health hubs in every community. Those fully funded and game-changing policies will make a real difference to tackling the mental health crisis that we face.
As we have heard, health and wellbeing services in Essex and across the country are facing extreme challenges. If we are privileged to get into government, Labour is determined to make a real difference for the people of Essex and this country by delivering more GPs, midwives, health visitors and mental health support and cutting waiting lists and times. We will deliver a mission-driven Government and break out of the current doom loop. We will push decisions out to communities and finally end the short-term sticking-plaster politics of this Government.
I will start with GPs, as securing the future of general practice is integral to the future of the NHS as a whole. GPs are vital to their communities and contribute hugely to keeping the nation healthy. However, the Government have broken their promise to recruit more than 6,000 GPs in the last five years. Ultimately, the NHS has lost the equivalent of 1,830 full-time, fully qualified GPs since 2015. There is a GP shortage crisis, and Essex is unfortunately on its frontline.
When we break down the numbers of patients per GP in the UK, Mid and South Essex ICB is worse than anywhere else in the country—I do not dispute that. There is one GP for every 2,281 patients. Staff shortages are a vicious cycle that leads to worsening outcomes, and we must train thousands more GPs to finally end that cycle. If we do not, we risk allowing the health of our nation, and the health of the people of Essex, to just get worse.
It is also worrying that the Care Quality Commission warned Mid and South Essex NHS Foundation Trust last summer over failings in three Essex hospitals. It found that medical care had deteriorated, with waiting times not meeting national standards and patients not accessing services when they needed them. The people of Essex deserve better care. They deserve to be seen on time, and to have local hospitals providing quality care for them when they need it most.
In recent years, elective waiting lists have risen sharply in every region and area of England. However, there are large geographical differences, with the east of England being one of worst affected areas. When we compare the figures with January 2020, the waiting list at the end of last year was 113% higher in the east of England. At the start of last year, the Prime Minister made a promise to the country to get NHS waiting lists down. Last month, he admitted the obvious—that he had failed. However, the reality is that the Government have failed in achieving most of the waiting list and waiting time targets since 2010. Unfortunately, that is a result of 14 years of successive Conservative Governments running the NHS.
I will quickly reflect on the worrying state of maternal health services in Essex. We face a crisis in maternity services across the country, with the CQC rating two out of three maternity units dangerously substandard. For the people of Essex, all but one maternity hospital unit is failing. Following the release of the final Ockenden report nearly two years ago, I urge the Minister to respond on the Government’s progress on implementing the report’s immediate and essential actions in trusts across the country. Safe care for women, babies and their families must be the top priority for our Government. It is clear that more needs to be done to improve care and safety in maternity services in England.
The Essex mental health inquiry has been covered in this debate, and I praise the grieving families and hard-working campaigners for their efforts in securing a statutory inquiry. In particular, I want to honour Melanie Leahy, whose son Matthew died more than 10 years ago in a mental health unit in Essex. She has never given up hope of getting justice and fighting to improve mental health provision in Essex and across the country, and she is an inspiration to us all.
Labour welcomed the announcement at that time, and I hope to hear an update from the Government today about progress on the Lampard inquiry. The Secretary of State offered to meet families last year, but that has yet to happen. The Guardian reported today that bereaved families have accused the Minister of dragging their feet over the inquiry into the death of almost 2,000 patients across NHS mental health trusts in Essex. I hope to hear from him about when that meeting is scheduled to take place and when the inquiry’s terms of reference are scheduled to be published.
I urge the Government to do all they can to ensure that the inquiry finally provides answers for the bereaved families, who have been waiting for far too long. While we are most determined to find answers to the specific inquiry, we must be clear that poor mental health services and standards are worryingly prevalent across other parts of the country. We continue to hear of other tragedies in mental health services; those are unacceptable. The Government must treat those incidences as a wake-up call and act in the light of the soaring number of investigations to prevent any further suffering or loss of life.
In recent years, one of the ways the Government could have acted would have been to deliver a reformed mental health Act. Reforms would have finally modernised legislation to strengthen people’s rights and choices within mental health settings. That was a manifesto pledge by the Government, and the Bill is ready to go—“oven-ready” as some on the Government Benches might have said previously. There is no excuse for the delay, but the Government have failed to get it done and deliver those much-needed changes. Labour has committed to introducing such a Bill in our first King’s Speech. Not only will it deliver real change to mental health services across the country, but it will deliver 8,500 new mental health specialists, mental health support in every school and open-access mental health hubs in every community. Those fully funded and game-changing policies will make a real difference to tackling the mental health crisis that we face.
As we have heard, health and wellbeing services in Essex and across the country are facing extreme challenges. If we are privileged to get into government, Labour is determined to make a real difference for the people of Essex and this country by delivering more GPs, midwives, health visitors and mental health support and cutting waiting lists and times. We will deliver a mission-driven Government and break out of the current doom loop. We will push decisions out to communities and finally end the short-term sticking-plaster politics of this Government.
15:33:37
Andrew Stephenson
The Minister for Health and Secondary Care
It is a pleasure to see you in the Chair, Mr Henderson—I think this is the first time I have responded to a debate while you have been in the Chair. It is a pleasure to respond to the debate, and I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing a debate on such an important subject. My further thanks go to my esteemed predecessor, my hon. Friend the Member for Colchester (Will Quince), not only for his work supporting his own constituency, but for his tireless efforts as a Health Minister and as my immediate predecessor in the Department. I also thank my right hon. Friend the Member for Maldon (Sir John Whittingdale) for his thoughtful contribution and the powerful advocacy that he always conducts on behalf of his constituents.
We all know that much of the continued recovery of the NHS following the pandemic is entirely dependent on the people who work in our NHS. I commend my hon. and right hon. Friends for the tributes they have paid to NHS staff. Our long-term workforce plan, which was raised by my hon. Friend the Member for Colchester, sets out the Government’s vision and commitment to ensuring that we have an NHS that can deliver for the future. Our plan commits to improving retention by improving culture and leadership to ensure that up to 130,000 fewer staff will leave the NHS over the next 15 years. It also sets out an aim to double the number of medical school places in England to 15,000 by 2031-32. That is our commitment to the future of the NHS moving forward, and there is cause for optimism now too. In recent months, the rate of staff leaving active service in the NHS has returned to pre-pandemic levels. In the east of England, the rate of staff leaving active service in the NHS has followed a similar pattern and is now below pre-pandemic levels. We know there is more to be done, but the plan is working.
The number of doctors and nurses is also on the rise. There are almost 6,800 more doctors and more than 21,500 more nurses in the NHS than last year. In the east of England, there are almost 740 more doctors and almost 1,700 more nurses in the NHS than last year. My hon. and right hon. Friends mentioned Anglia Ruskin University. I had the huge privilege of visiting the university on 4 March to meet some of the medical students. If there is anything that gives a person optimism about the future of the NHS, it is sitting down and having a roundtable with some of the medical students in a university such as Anglia Ruskin, which has gone from strength to strength over recent years thanks to the campaigning of local MPs who have championed investment in that university.
Medical training at our best medical institutions is an essential part of delivering the long-term workforce plan. I therefore welcome Anglia Ruskin University’s commitment to the medical degree apprenticeship and recognise that it is a trailblazer. The university can bid for additional Government-funded places, in common with all existing medical schools across England, and I look forward to continuing to work with it and local MPs to secure more investment in the university.
We know that the NHS faces pressures all over the country, including in Essex and the east of England more broadly. As a Government, we are committed to working every day to improve the outcomes and experiences of patients. A huge part of that is making sure that patients get to talk to a GP. I am glad to say that since 2019 we have recruited more than 36,000 additional staff into general practice, covering a range of roles including pharmacists. We fulfilled our commitment to recruit 26,000 additional staff a year ahead of the March 2024 target, and we have also delivered on our manifesto commitment of 50 million more general practice appointments a year, with 367.7 million booked appointments across the past 12 months.
Looking more closely at the constituency of my right hon. Friend the Member for Witham, I am pleased to say that there are now approximately 105 full-time equivalent members of the clinical general practice workforce. That is an increase of 62% since September 2019, when there were about 65 full-time equivalent staff in the clinical workforce. In the east of England, there are now approximately 3,909 full-time equivalent GPs and an estimated 3.7 million general practice appointments took place in January 2024, with 72% of those face to face. In Witham specifically, 76% of appointments in January 2024 were face to face, up from 68.5% in January 2023. All the same, I commend my right hon. Friend for her tenacious advocacy of a new health hub for Witham. Her constituents are fortunate to have such a doughty champion, with a deep and genuine care for their access to the health service.
Mid and South Essex ICB has confirmed that GP practices in Witham are working together to help meet the health needs of local residents by sharing staff, teams and services. However, as my right hon. Friend acknowledged in her speech, the financial complexities of bringing GP estates together can be multifaceted and challenging. Mid and South Essex ICB has confirmed that transitioning to a new building would involve complex considerations surrounding property ownership, leasing arrangements and financial investments. The ICB is also concerned that while section 106 monies serve as a valuable contribution to local NHS healthcare provision, the money available may fall short in sustaining the entire development of a new healthcare centre. I hope my right hon. Friend and the ICB can continue to work together to think carefully through those challenges and find the best solution that meaningfully responds to the needs of Witham’s patients.
I also thank my right hon. Friend for her comments about the future of St Peter’s Hospital, which I know is a subject dear to her heart and to the heart of my right hon. Friend the Member for Maldon. As she said, it is generating an unprecedented reaction from her constituents. I will keep my comments on this issue brief, knowing that another debate on it will take place on Thursday. That will provide a longer opportunity for my right hon. Friends, particularly my right hon. Friend the Member for Maldon, to build and expand on the concerns that my right hon. Friend the Member for Witham has set out today.
Let me be clear that no decision has yet been made about the future of St Peter’s. Any decision regarding the future configuration of NHS services in Mid and South Essex should be made locally, following engagement with local communities. I am sure that local views are being listened to and, as my right hon. Friend the Member for Witham said, an NHS consultation is currently live. I urge both her and my right hon. Friend the Member for Maldon, and their constituents, to participate in it actively.
I expect any subsequent decision taken by the local NHS to demonstrate improved outcomes for patients, having taken into account all of the many issues that my right hon. Friend the Member for Witham has outlined today, which I am sure will be further expanded upon on Thursday.
I want to reassure both my right hon. Friends. In my constituency, an unpopular reorganisation of local health services in east Lancashire under the last Labour Government in 2007 removed a significant number of health services in my constituency and transferred them to Blackburn, so I am very conscious of the potential impacts of hospital reorganisations and I always look at these matters very closely and pay close attention to the views of local Members of Parliament.
I turn to the subject of urgent and emergency care. We absolutely recognise the pressures that these services are facing and we are working to ensure that people receive the care they need when they need it. Although we recognise that there is more to do, we have seen performance improve this year.
For example, at the Mid and South Essex NHS Foundation Trust 67.3% of accident and emergency patients were seen within four hours in January 2024, which was better than the trust’s performance in January 2023. At the East Suffolk and North Essex NHS Foundation Trust, 72.2% of A&E patients were seen within four hours in January 2024—performance above the national average. Ambulance handover delays, which have a big impact on response times, have reduced significantly this winter compared with last year. At the Mid and South Essex NHS Foundation Trust, delays of over 60 minutes have fallen by 48%. Nationally, we have seen progress on ambulance response times, with the average ambulance waits for category 2 incidents down by over a third this winter.
We have heard today about the continuing difficulties that patients have in accessing a dentist. That is deeply unfortunate and it is essential that we give patients access to the dental care that they deserve. That is why, on 7 February, we published our plan to recover and reform dentistry, to make dental services faster, simpler and fairer for patients. The plan will fund around 2.5 million additional appointments; our plan to recover and reform NHS dentistry is backed by £200 million.
Hon. Members also mentioned the important role of community pharmacy. Community pharmacy is delivering healthcare, which makes an extremely valuable contribution to patients’ lives. That is why we are continuing to support the sector financially, and we are providing over £2.6 billion every year to support community pharmacy. To go further, we are now investing up to £645 million across this financial year and the next in Pharmacy First, which will allow for more blood pressure checks and more contraception consultations in pharmacy.
I will now address some of the concerns expressed regarding the Lampard inquiry, which is an issue of the utmost importance and sensitivity. I completely recognise the desire of families and other stakeholders that the terms of reference of the inquiry be finalised as soon as possible, so that the inquiry can make progress with its investigations. Let me update my hon. and right hon. Friends on the most recent discussions.
Following consultation with families and other stakeholders, the chair of the Lampard inquiry has shared her initial views on potential changes to the terms of reference. On 5 December, my right hon. Friend the Secretary of State for Health and Social Care agreed to meet families and local MPs in Essex to discuss the terms of reference. On 6 March, as referred to by both my right hon. Friends today, the local MPs and I met to discuss the inquiry. We agreed that my right hon. and hon. Friends across Essex would put forward names of family members to attend a meeting with the Secretary of State, so that she could hear directly from the families herself.
We have now identified a potential date for that meeting, and that will be communicated very shortly to local MPs, if it has not been already; the date will be emailed out by my office. I hope that the meeting can take place on that date, and that we can make the swift progress that we all want to see. Families have been waiting far too long. Again, I commend my hon. and right hon. Friends for their work to shine a light on what has gone on and to ensure that the inquiry was established, and I hope that it can finally get on with its work and deliver the outcomes and justice that the families all want to see.
I will wrap up by addressing one of the most important elements in the future of healthcare: prevention. I reiterate the Government’s commitment to our levelling-up mission to narrow the gap in healthy life expectancy by 2030 and to increase healthy life expectancy by five years by 2035. To do that, we are tackling health inequalities through programmes such as the NHS’s Core20PLUS5, which focuses on improving health outcomes for the poorest 20% of the population as well as other groups.
Furthermore, we will publish our major conditions strategy this year, a direction-setting document aiming to pave the way for further action towards integrated care, co-ordinated around the needs of people. It aims to improve healthy life expectancy, reduce pressures on the NHS and reduce ill health-related labour market inactivity. Together, those programmes will help us shift the dial, both nationally and in Essex, on NHS pressures.
I thank my hon. and right hon. Friends for their contributions, and once again thank my right hon. Friend the Member for Witham for securing the debate. I hope my answers have helped to assure all those who have attended that we are firmly committed to delivering for the health and wellbeing needs of people in Essex and across the country.
We all know that much of the continued recovery of the NHS following the pandemic is entirely dependent on the people who work in our NHS. I commend my hon. and right hon. Friends for the tributes they have paid to NHS staff. Our long-term workforce plan, which was raised by my hon. Friend the Member for Colchester, sets out the Government’s vision and commitment to ensuring that we have an NHS that can deliver for the future. Our plan commits to improving retention by improving culture and leadership to ensure that up to 130,000 fewer staff will leave the NHS over the next 15 years. It also sets out an aim to double the number of medical school places in England to 15,000 by 2031-32. That is our commitment to the future of the NHS moving forward, and there is cause for optimism now too. In recent months, the rate of staff leaving active service in the NHS has returned to pre-pandemic levels. In the east of England, the rate of staff leaving active service in the NHS has followed a similar pattern and is now below pre-pandemic levels. We know there is more to be done, but the plan is working.
The number of doctors and nurses is also on the rise. There are almost 6,800 more doctors and more than 21,500 more nurses in the NHS than last year. In the east of England, there are almost 740 more doctors and almost 1,700 more nurses in the NHS than last year. My hon. and right hon. Friends mentioned Anglia Ruskin University. I had the huge privilege of visiting the university on 4 March to meet some of the medical students. If there is anything that gives a person optimism about the future of the NHS, it is sitting down and having a roundtable with some of the medical students in a university such as Anglia Ruskin, which has gone from strength to strength over recent years thanks to the campaigning of local MPs who have championed investment in that university.
Medical training at our best medical institutions is an essential part of delivering the long-term workforce plan. I therefore welcome Anglia Ruskin University’s commitment to the medical degree apprenticeship and recognise that it is a trailblazer. The university can bid for additional Government-funded places, in common with all existing medical schools across England, and I look forward to continuing to work with it and local MPs to secure more investment in the university.
We know that the NHS faces pressures all over the country, including in Essex and the east of England more broadly. As a Government, we are committed to working every day to improve the outcomes and experiences of patients. A huge part of that is making sure that patients get to talk to a GP. I am glad to say that since 2019 we have recruited more than 36,000 additional staff into general practice, covering a range of roles including pharmacists. We fulfilled our commitment to recruit 26,000 additional staff a year ahead of the March 2024 target, and we have also delivered on our manifesto commitment of 50 million more general practice appointments a year, with 367.7 million booked appointments across the past 12 months.
Looking more closely at the constituency of my right hon. Friend the Member for Witham, I am pleased to say that there are now approximately 105 full-time equivalent members of the clinical general practice workforce. That is an increase of 62% since September 2019, when there were about 65 full-time equivalent staff in the clinical workforce. In the east of England, there are now approximately 3,909 full-time equivalent GPs and an estimated 3.7 million general practice appointments took place in January 2024, with 72% of those face to face. In Witham specifically, 76% of appointments in January 2024 were face to face, up from 68.5% in January 2023. All the same, I commend my right hon. Friend for her tenacious advocacy of a new health hub for Witham. Her constituents are fortunate to have such a doughty champion, with a deep and genuine care for their access to the health service.
Mid and South Essex ICB has confirmed that GP practices in Witham are working together to help meet the health needs of local residents by sharing staff, teams and services. However, as my right hon. Friend acknowledged in her speech, the financial complexities of bringing GP estates together can be multifaceted and challenging. Mid and South Essex ICB has confirmed that transitioning to a new building would involve complex considerations surrounding property ownership, leasing arrangements and financial investments. The ICB is also concerned that while section 106 monies serve as a valuable contribution to local NHS healthcare provision, the money available may fall short in sustaining the entire development of a new healthcare centre. I hope my right hon. Friend and the ICB can continue to work together to think carefully through those challenges and find the best solution that meaningfully responds to the needs of Witham’s patients.
I also thank my right hon. Friend for her comments about the future of St Peter’s Hospital, which I know is a subject dear to her heart and to the heart of my right hon. Friend the Member for Maldon. As she said, it is generating an unprecedented reaction from her constituents. I will keep my comments on this issue brief, knowing that another debate on it will take place on Thursday. That will provide a longer opportunity for my right hon. Friends, particularly my right hon. Friend the Member for Maldon, to build and expand on the concerns that my right hon. Friend the Member for Witham has set out today.
Let me be clear that no decision has yet been made about the future of St Peter’s. Any decision regarding the future configuration of NHS services in Mid and South Essex should be made locally, following engagement with local communities. I am sure that local views are being listened to and, as my right hon. Friend the Member for Witham said, an NHS consultation is currently live. I urge both her and my right hon. Friend the Member for Maldon, and their constituents, to participate in it actively.
I expect any subsequent decision taken by the local NHS to demonstrate improved outcomes for patients, having taken into account all of the many issues that my right hon. Friend the Member for Witham has outlined today, which I am sure will be further expanded upon on Thursday.
I want to reassure both my right hon. Friends. In my constituency, an unpopular reorganisation of local health services in east Lancashire under the last Labour Government in 2007 removed a significant number of health services in my constituency and transferred them to Blackburn, so I am very conscious of the potential impacts of hospital reorganisations and I always look at these matters very closely and pay close attention to the views of local Members of Parliament.
I turn to the subject of urgent and emergency care. We absolutely recognise the pressures that these services are facing and we are working to ensure that people receive the care they need when they need it. Although we recognise that there is more to do, we have seen performance improve this year.
For example, at the Mid and South Essex NHS Foundation Trust 67.3% of accident and emergency patients were seen within four hours in January 2024, which was better than the trust’s performance in January 2023. At the East Suffolk and North Essex NHS Foundation Trust, 72.2% of A&E patients were seen within four hours in January 2024—performance above the national average. Ambulance handover delays, which have a big impact on response times, have reduced significantly this winter compared with last year. At the Mid and South Essex NHS Foundation Trust, delays of over 60 minutes have fallen by 48%. Nationally, we have seen progress on ambulance response times, with the average ambulance waits for category 2 incidents down by over a third this winter.
We have heard today about the continuing difficulties that patients have in accessing a dentist. That is deeply unfortunate and it is essential that we give patients access to the dental care that they deserve. That is why, on 7 February, we published our plan to recover and reform dentistry, to make dental services faster, simpler and fairer for patients. The plan will fund around 2.5 million additional appointments; our plan to recover and reform NHS dentistry is backed by £200 million.
Hon. Members also mentioned the important role of community pharmacy. Community pharmacy is delivering healthcare, which makes an extremely valuable contribution to patients’ lives. That is why we are continuing to support the sector financially, and we are providing over £2.6 billion every year to support community pharmacy. To go further, we are now investing up to £645 million across this financial year and the next in Pharmacy First, which will allow for more blood pressure checks and more contraception consultations in pharmacy.
I will now address some of the concerns expressed regarding the Lampard inquiry, which is an issue of the utmost importance and sensitivity. I completely recognise the desire of families and other stakeholders that the terms of reference of the inquiry be finalised as soon as possible, so that the inquiry can make progress with its investigations. Let me update my hon. and right hon. Friends on the most recent discussions.
Following consultation with families and other stakeholders, the chair of the Lampard inquiry has shared her initial views on potential changes to the terms of reference. On 5 December, my right hon. Friend the Secretary of State for Health and Social Care agreed to meet families and local MPs in Essex to discuss the terms of reference. On 6 March, as referred to by both my right hon. Friends today, the local MPs and I met to discuss the inquiry. We agreed that my right hon. and hon. Friends across Essex would put forward names of family members to attend a meeting with the Secretary of State, so that she could hear directly from the families herself.
We have now identified a potential date for that meeting, and that will be communicated very shortly to local MPs, if it has not been already; the date will be emailed out by my office. I hope that the meeting can take place on that date, and that we can make the swift progress that we all want to see. Families have been waiting far too long. Again, I commend my hon. and right hon. Friends for their work to shine a light on what has gone on and to ensure that the inquiry was established, and I hope that it can finally get on with its work and deliver the outcomes and justice that the families all want to see.
I will wrap up by addressing one of the most important elements in the future of healthcare: prevention. I reiterate the Government’s commitment to our levelling-up mission to narrow the gap in healthy life expectancy by 2030 and to increase healthy life expectancy by five years by 2035. To do that, we are tackling health inequalities through programmes such as the NHS’s Core20PLUS5, which focuses on improving health outcomes for the poorest 20% of the population as well as other groups.
Furthermore, we will publish our major conditions strategy this year, a direction-setting document aiming to pave the way for further action towards integrated care, co-ordinated around the needs of people. It aims to improve healthy life expectancy, reduce pressures on the NHS and reduce ill health-related labour market inactivity. Together, those programmes will help us shift the dial, both nationally and in Essex, on NHS pressures.
I thank my hon. and right hon. Friends for their contributions, and once again thank my right hon. Friend the Member for Witham for securing the debate. I hope my answers have helped to assure all those who have attended that we are firmly committed to delivering for the health and wellbeing needs of people in Essex and across the country.
Priti Patel
I am grateful for the opportunity to discuss these important health issues across Essex. I pay tribute to my right hon. Friend the Member for Maldon (Sir John Whittingdale) and my hon. Friend the Member for Colchester (Will Quince) for joining the debate, and to the Minister for a concise series of well-considered remarks. We have touched on a range of issues, including the challenging demographics of the county of Essex and the needs of populations, and key areas covering primary care services, GP-patient ratios, our hospitals, the need to safeguard the facilities of Maldon St Peter’s Hospital, the need to secure a health centre in Witham town, the growing needs in Tiptree itself and the significant demands on social care.
I thank everybody for their comments on the EPUT statutory mental health inquiry, which is particularly sensitive, difficult and challenging. I pay tribute to the Minister for meeting us last week, and his comments on meeting the families are crystal clear. I thank his private office, which contacted us MPs today—in less than a week—to ask for the specifics that we have discussed. It is important that we can go back to those families with the information that a meeting with the Secretary of State will take place very soon.
My final comment is to echo my right hon. Friend the Member for Maldon: the inquiry has been going on for too long. We need to find the right balance of redress and parity of esteem in the whole mental health debate. However, while the inquiry takes place, we also need to find the right services and support for the families and the lawyers in particular.
It has been a pleasure to secure this debate and raise these issues. I thank all hon, and right hon. Members for their important contributions. There is more to do, and we will be back to discuss the same issues again.
Question put and agreed to.
Resolved,
That this House has considered health and wellbeing services in Essex.
I thank everybody for their comments on the EPUT statutory mental health inquiry, which is particularly sensitive, difficult and challenging. I pay tribute to the Minister for meeting us last week, and his comments on meeting the families are crystal clear. I thank his private office, which contacted us MPs today—in less than a week—to ask for the specifics that we have discussed. It is important that we can go back to those families with the information that a meeting with the Secretary of State will take place very soon.
My final comment is to echo my right hon. Friend the Member for Maldon: the inquiry has been going on for too long. We need to find the right balance of redress and parity of esteem in the whole mental health debate. However, while the inquiry takes place, we also need to find the right services and support for the families and the lawyers in particular.
It has been a pleasure to secure this debate and raise these issues. I thank all hon, and right hon. Members for their important contributions. There is more to do, and we will be back to discuss the same issues again.
Question put and agreed to.
Resolved,
That this House has considered health and wellbeing services in Essex.
Sitting suspended.
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