Contribution
I thank the hon. Member for his contribution. I will come to that point shortly.
East Riding patients travelled an astonishing 2.7 million NHS miles to attend out-patient appointments in 2023-24, and two thirds of Bridlington residents attend out-patient appointments away from the town. That is not acceptable, and I will not stand by and let it continue. However, part of the problem is that local Members of Parliament have very little, if any, direct influence over the direction of our health services, which is why I am appealing to the Minister for his support. I believe that this is particularly timely.
In his recent report, Lord Darzi described the NHS as “broken”, and in the case of Bridlington he is correct. He states that:
“An ageing population is the most significant driver of increased healthcare needs since it is associated with the development of long-term conditions”
and that
“by the time people are aged 65-74, a majority will have at least one long-term condition and some 40 per cent will have two or more. By the time people are aged 75-84, this rises to nearly 60 per cent having two or more, and by the time people are aged 85 or above, 9 out of 10 will have at least one long-term condition.”
I remind the House that one third of residents in Bridlington are over 65.
Lord Darzi makes the following very pertinent observation:
“At the highest level, the NHS has had the strategic intention to shift spending from reactive care in hospitals to more proactive care in the community setting—but care has in fact moved in the other direction.”
That is very much the experience of my constituents. The report also makes it clear that “care should be more joined up, or more ‘integrated’…to reflect the fact the people living with long-term conditions”
need more support and
“a variety of different physical and mental health professionals and often rely on social care too. The frequency of their interactions with the health service means that their care is more complex and therefore requires coordination.”
Finally on this point, Lord Darzi is right to say that
“care should be delivered in the community, closer to where people live and work”,
and that
“hospitals should be reserved for specialist care. This is more convenient for patients—especially for those with long-term conditions who will need contact with the NHS more frequently.”
I would also like to refer the House to the chief medical officer’s 2021 annual report on health in coastal communities. In this insightful piece of work, Sir Chris Whitty noted:
“Given the known high rates of preventable illness in these areas, the lack of available data on the health of coastal communities has been striking whilst researching the report. Coastal communities have been long overlooked with limited research on their health and wellbeing. The focus has tended towards inner city or rural areas with too little attention given to the nation’s periphery.”
He went on to add:
“Data is rarely published at a geographical level granular enough to capture coastal outcomes, with most data only available at local authority or Clinical Commissioning Group (CCG) level. As a result, deprivation and ill health at the coast is hidden by relative affluence just inland which is lumped together.”
In conclusion, he recommended:
“Given the health and wellbeing challenges of coastal communities have more in common with one another than inland neighbours, there should be a national strategy to improve the health and wellbeing of coastal communities.”
Unfortunately, and perhaps as a result of the health service working its way through the impact of the pandemic, the report has been somewhat sidelined and the recommendations have yet to be acted upon, so what should be the solution?
We need a comprehensive strategy, bringing together all parts of the health service, that recognises the challenges and put together an immediate action plan. The Humber and North Yorkshire integrated care board is trying to address these issues, but I am concerned about exactly what its role is, or should be. Some ICBs interpret their population health duties as requiring them to act upstream of healthcare needs on the social determinants of health, where the NHS has few direct levers. Other ICBs interpret their duties as requiring them to understand and adjust healthcare services to match the needs of the population that they serve, in line with the NHS operating framework. Some interpret them as both and others as neither, preferring to focus on what they see as their traditional role of performance managing providers. Ultimately, their roles and responsibilities need to be clarified so that they can be better held to account. This is not a criticism of the performance of my local ICB, which is working hard to tackle the challenges, but I think we would all benefit from greater clarity of purpose.
In conclusion, we cannot escape what is in front of us. As one senior local authority figure commented to me:
“The health crisis in Bridlington is not a car crash waiting to happen, it is happening right now.”
My appeal to the Minister today is simple. I have no doubt that he has the very best of intentions when it comes to improving the nation’s health, but realistically many of those ambitions will take decades. If he wants to make a real difference today, will he please focus some of his Department’s collective effort on tackling the enormous health inequalities in seaside towns such as Bridlington, and will he please take the recommendations of Lord Darzi and Sir Chris Whitty and apply them to our town? We are happy to be his pilot scheme or his trailblazer.
I know that with the right energy and direction, we will not be left with a generation of children who have never seen a dentist and we will not have elderly people travelling long distances for regular routine appointments. Instead, we will have a health service to be proud of and a happier and healthier local population. I implore the Minister and his Department to work with me to ensure a better future for the brilliant people of Bridlington.