Dr Roz Savage

I absolutely agree with the hon. Lady’s point. I have been pressing the NHS to find out the criteria by which they will judge the trial closure, but the criteria have not been forthcoming. I am concerned that there is a circular logic: “Well, you’ve managed without that ward for six months or a year, so you can continue to manage without it.” A constituent described a cardiac arrest at Cirencester, handled with what she called “absolute skill and excellence” by a team of senior staff working together to stabilise the patient before transfer to an acute hospital. She told me that the nursing care on the wards is excellent, and that patients nearing the end of their lives are cared for with compassion and great dignity. That is what we are talking about when we talk about community hospitals, and that is what the trial closure of a ward potentially puts at risk. Another constituent—a former GP who started practicing in Cirencester 40 years ago, in 1986—told me about a child who, after the surgical ward closed, waited 20 hours in Cheltenham for an appendix operation. Previously, that operation could have been done in Cirencester much more quickly. That is a family sitting in a corridor in an unfamiliar hospital at 2 in the morning, feeling anxious and far from home, because the local service they relied on had gone. A month or so ago I launched a petition, in collaboration with a local county councillor, to protect community hospitals across the Cotswolds. Within a couple of weeks, well over 3,000 people had signed it, and last week we handed it in at No. 10. The South Cotswolds population is growing rapidly, largely due to the Government’s housing targets. Thousands of new houses are being built around Cirencester, and there are plans for many more housing developments that will swallow up nearby villages. It does not make mathematical sense for communities to grow while the services that support them shrink. The numbers just do not add up. NHS bodies often describe these changes as reconfigurations—a shift in how care is delivered rather than a reduction in what is available. For a rural resident with no car and negligible public transport, a 25-mile journey to Cheltenham is a significant barrier to care. The Government’s own 10-year plan talks about “neighbourhood health” and care “closer to home”, but Gloucestershire is heading in the direct opposite direction. I would like to hear from the Minister how those two things can be reconciled. A few miles to the north-west of my constituency, post-natal beds at Stroud maternity hospital were suspended in 2022. That year, the Care Quality Commission rated Gloucestershire’s maternity services as inadequate—a rating they retained on reinspection the following year. The hon. Member for Stroud (Dr Opher), who is a GP, has made the valid point that post-natal care saves money downstream because it is the time when mothers and babies bond, when breastfeeding is established and when families who need extra support get it on a timely basis. If we lose that support, the costs will appear elsewhere later on. Will the Minister provide a timeline, with dates, for the full restoration of maternity services in Gloucestershire, including the Aveta ward in Cheltenham, which is currently closed for labour and births? Will she provide details of the specific workforce support the Government are providing to make that happen? In other countries, the decline of community hospitals is not seen as inevitable. Other countries are under the same pressures, but they are making different choices. In Sweden, research found that rural GPs value community hospitals because they provide exactly the things that cannot be replicated in a large acute centre, including proximity, continuity and a holistic understanding of elderly patients and others with multiple conditions. Heart failure and pneumonia rehabilitation can be managed closer to home by staff who know the patient and their family. In Italy, the Government have committed to building or renovating 400 community hospitals using European recovery funds, backed by research from the Emilia-Romagna region showing that they deliver better integration among care sectors, between primary and specialist staff, and between healthcare and the communities it serves. Last October, more than 150 people from 23 countries joined an international webinar co-hosted by the Community Hospitals Association, and the conclusion was consistent: community hospitals anchor care in local communities, support home-based care and help people to live better for longer. The Government’s NHS 10-year plan commits to shifting care from hospital to community. That sounds like a very good idea, but a Nuffield Trust report published in September 2025 makes a point that needs to be heard: this ambition is not new. Successive Governments have promised to move care closer to home, and most have fallen short, almost always because the community infrastructure needed to enable the shift is simply not there, and nor is the investment. Ireland, which has pursued reform for nearly a decade, had the wisdom to invest up front in new facilities, digital systems and community workforce capacity. Unfortunately, the Nuffield Trust found that England’s 10-year plan contains no equivalent ringfenced funding. The expectation appears to be that hospitals cut waiting lists and simultaneously release funds to build community capacity. Again, the maths just does not work. The starting point is already challenging. More than 1.1 million people are currently waiting for community care in England, with the steepest rise among children and young people. A hospital where the theatre has been paused cannot absorb more community care. A maternity unit closed for three years cannot deliver neighbourhood health. A community health system with 1.1 million people already waiting cannot become the landing ground for patients displaced from acute settings unless it is properly resourced to do so. As so often, rural areas pay the highest price when the gap between ambition and delivery opens up. There is no slack in the system and no easily accessible option down the road.