Richard Foord

It is an honour to serve with you in the chair, Mr Stuart. I am grateful to my hon. Friend the Member for Chelmsford (Marie Goldman) for securing the debate. When we discuss underperforming trusts, we must recognise that some NHS trusts are operating in circumstances that would challenge even the best management teams. The Royal Devon University Healthcare NHS foundation trust serves a largely rural and coastal population, with an ageing demographic, workforce pressures and significant barriers to access. I do not want to blame the Royal Devon leadership team. This is certainly not about blaming hard-working staff, because they do a brilliant job in very trying circumstances. But let us face it: the geography and demographics are stacked against them. The chief medical officer, Sir Chris Whitty, has repeatedly highlighted the unique health challenges facing rural and coastal communities, including when he visited Devon in May this year. Sir Chris has warned of “the health challenges of coastal towns”, and that attracting staff in such areas is significantly harder, noting that transport links are often limited. In his 2023 report Sir Chris warned: “People living in peripheral areas experience issues relating to accessing primary and secondary healthcare, domiciliary care, medicines, shopping and transport. The response times of health care professionals are often longer because of the distances involved, which is particularly important for emergency presentations”. Steve Brown, the director for public health in Devon, said: “In Devon, our records show that some people are dying up to 15 years earlier than they should because essential building blocks of health…like reliable transport…and services that people can reach…are missing.” My constituent Hilary Robarts-Arnold, from Seaton, wrote to me to describe the lack of transport and the difficulty of getting services in east Devon. Her husband is increasingly frail and suffers from skin cancer. Until recently, he attended dermatology services at Axminster hospital, seven and a half miles away. Those local services have now gone, and patients are instead forced to trek to Exeter, if they can. For her and her husband, that would be 22 miles, which is simply not possible because it is just too challenging a distance. As a result, his cancer is not being dealt with. The RDUH told me that “this is a workforce and capacity issue, not a reflection of the clinical priority we place on patient care”. If Government oversight of NHS trusts is to be meaningful, they must recognise the realities of rural and coastal healthcare and weight funding accordingly.