Coastal Communities (Health) Bill
Friday, 13 November 2026
Contributions
Second Reading
Steff Aquarone (North Norfolk) (LD)Liberal Democrat
I beg to move, That the Bill be now read a Second time. It is my privilege to introduce this Bill today. I thank the Clerks from the Public Bill Office for their support in bringing it to life, and colleagues from along our coastline for their expressions of support for it. Along our coast, people live sicker and die younger. Five years ago, the chief medical officer laid out the evidence, and today this House has an opportunity to act on it. Fresh from steering the nation through the pandemic, Professor Sir Chris Whitty sought to tackle another major challenge: he published a seminal report outlining the health inequalities faced by coastal communities across our country, which include mine in North Norfolk. The findings are stark and shocking, but clear: across a range of measurable factors, those living in coastal communities were worse off—higher rates of coronary heart disease, lung conditions, obesity, substance abuse and addiction, and mental ill health. Their life expectancies were lower, and the percentage of those lives lived in good health was lower, too. We are an island nation. For an island nation to have poorer health outcomes in coastal areas is an unacceptable failing. The evidence exists, and the recommendations exist. What is missing is a system that turns them into action and makes someone answerable when that action falls short. The things that Professor Whitty outlined are not news to many of us in coastal communities. We understand the challenges we face, and we live with them daily. What they exposed is how much coastal communities have in common in facing down these challenges, and how much more we have in common with our coastal neighbours than we do with many of our inland neighbours. Our coastal communities could be a powerful force, and they need to be if the Government are to deliver their ambitions for growth, green energy, strengthened industry, and national defence and security. If our communities are sicker, those aims will all be harder to achieve. For too long, the issues of health and wellbeing in our coastal communities have not been part of the wider conversation about tackling health inequality. I introduced this Bill because I am determined to ensure that my community in North Norfolk, and communities anywhere on our nation’s coast, is being properly represented. Let us look at the inarguable facts. Professor Whitty’s findings continue to stack up with more recent research. An article published just weeks ago in the Journal of Public Health found that coastal communities in the south-east have life expectancy four years lower than their inland neighbours. In the east of England, it is three years lower. I have spoken before about how these inequalities can even be seen within counties; there are notable differences in life expectancy at either end of the Acle Straight in Norfolk, between Broadland and Great Yarmouth, despite their being only a few miles apart. Research from University College London, published in the British Medical Journal over the summer, also shocked me. It spoke of “people who grew up and stayed in coastal areas becoming more likely to develop morbidity from midlife compared with those staying in inland areas and…the people who move to coastal areas are sicker compared with those who move away from coastal areas.” I want the House to reflect on that for a moment. We have evidence that suggests that for people in coastal communities, the best way to stay healthy could be to leave—and for those who are not there currently, not to move there. This is an existential threat to coastal communities as we know them. Action is not a choice any more; it is a necessity. This matters to the Minister with responsibility for health inequalities, the right hon. Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), who is not in her place today. She is a respected champion and hard worker for the fine city of Hull. In her area, people will live only 53 years of their life in good health. The average age of MPs elected to this place in 2024 was 48, so were the average MP to become an average resident of Hull, they would have only five years of good health left. I am sure many of us still have a great many things we wish to do in our lives that are reliant on our good health. How would we react to being told that we had five years before our health started to become noticeably and impactfully poorer? That is not acceptable for the people who live anywhere in the country, and I implore the Minister to support the Bill and make a change for all our coastal constituents. The Bill makes two straightforward demands: a duty to act and a strategy that brings Government together to deliver. As I said during the Health Bill debate, the Government’s current aim to have a duty to tackle health inequality is commendable, but as drafted it is flawed. There are no safeguards to ensure that coastal communities see the benefits of any of this work. Being at the end of the line, often disparately populated and with difficult challenges to tackle, makes it possible that the Government will overlook such communities in favour of tackling health inequality in larger, inland metropolitan areas.
Sean Woodcock (Banbury) (Lab)Labour
I congratulate the hon. Member on introducing an important debate on health inequalities to the House. My constituency is inland but largely rural, and shares similar issues with health inequalities to those that he raises, because of transport and access to services. Does he think that by confining the discussion to coastal communities he is stifling a much more important debate about health inequalities across the country more generally?
In fact, I would say to the hon. Member that in order to tackle inequality truly we need to work from the outside in. In doing so, we would surely bring into line all the rural inland communities of which he speaks, which I do not doubt share many of the same issues that I am discussing today. If we start with the places the system finds hardest to reach, then we can design services that work there and work inwards. Otherwise, a national average can improve while the communities with the greatest barriers are left exactly where they were.
Amanda Martin (Portsmouth North) (Lab)Labour
Does the hon. Member agree that the men’s health strategy is working from within, and that having diagnostic, GP and mental health services available at farming auctions is a great move forward by this Government?
That is a wonderful example of how designing from the outside in can work. We have seen that with buses and with broadband, and it is plain that we suffer the same with all forms of health services. The former Health Secretary, the right hon. Member for Ilford North (Wes Streeting), said: “If Australia can effectively serve communities living in the remote outback, we can meet the needs of people living in rural and coastal England.”
Caroline Voaden (South Devon) (LD)Liberal Democrat
In my constituency it can take a very long time to get to the nearest hospital because of small, narrow lanes, and it can be almost impossible in the summer when there is heavy holiday traffic. The integrated care board has talked about merging emergency cardiac care between three hospitals, which would make the journey so long that people would literally die en route to the hospital. We have been campaigning hard for the ICB not to do that. Does my hon. Friend agree that while merging some services may be the way forward to enable ICBs to cover their costs, choosing a service like emergency cardiac care, where the time taken to get to the hospital, and therefore the distance travelled, is absolutely crucial to survival, is the wrong area to start when looking at service provision?
That surely defies all sense. I understand, as my hon. Friend alluded to, that for reasons of professional development and training it may not be possible to deliver all services in all areas, but acute and emergency care is surely beyond reproach. I am yet to hear any understanding or potential safeguards for that risk from the Government, either here or in the other place. There was no acknowledgment of it when I brought forward and spoke to an amendment on the Health Bill, or when Lord Patel did so in the other place. Coastal communities deserve an explanation of why the Government are not ensuring that health services are delivered for them.
Pam Cox (Colchester) (Lab)Labour
The east of England has one of the longest coastlines of any region, so we too are familiar with the challenges faced by coastal communities. The University of Essex has an exemplary centre for coastal communities, led by Dr Emily Murray, an epidemiologist and public health expert. Will the hon. Gentleman join me in commending the work of that centre and in encouraging Ministers to meet representatives from the centre to hear their recommendations?
I surely would, on condition that the hon. Lady allows me to join them, because I would really like to hear more about that work. I am sure it would have a great impact on my part of the east of England, which is quite a big part of the United Kingdom. When I have tried to question the Government on the specifics of their work, I have not received anything substantive. In July, I asked how many meetings the Minister for health disparities had attended in relation to coastal health inequalities this year, and I was told: “Ministers in the Department meet regularly on a range of topics, including tackling health inequalities, to which coastal inequalities are closely linked.” I asked which meetings had taken place; I received a general assurance. I asked what specific work was being done, and I was referred back to that general assurance. Ministers must be able to tell Parliament what they are doing, who is responsible and what has changed. It is becoming a worrying theme that coastal health inequality is being kicked out to sea, so I hope the Minister can provide some straight answers on what the Government have done and will do to make a difference. People in coastal communities want the reassurance that this House, which has more than 100 MPs who represent coastal communities, is placing a legal duty on Ministers responsible for tackling the issues that matter to them. This lack of action or record of delivery is growing more and more worrying. The other part of my Bill relates to a cross-governmental coastal health strategy. It is rare for politicians to admit when an idea is not theirs, but I will admit that this is not my idea. In fact, it is not even very new. It was a core recommendation of the Chris Whitty report in 2021. I am sure that the Government will be keen to point out their existing health plans and strategies. While those do important work in places, they will not do enough to recognise the specific challenges of delivering coastal healthcare. Coastal communities suffer from the challenge of the half-compass effect when seeking access to healthcare. It might sound obvious, but when residents in Mundesley or Cley seek to access healthcare, half the compass directions they could travel in would take them straight into the North sea. To my knowledge we are not yet building GP surgeries or dentists there. Yet we still risk planning services as though patients can travel in every direction. This morning I received a letter from a constituent in Holt, who had been referred by his GP for an MRI scan but was told there was only availability at the Norfolk and Norwich hospital, some 25 miles away. It is a six-hour round trip on public transport. He cannot afford a taxi and there is no hospital transport available, so he has declined the test. He asked me, rightly, how many other constituents find themselves in this situation because of inadequate access to healthcare on the coast. Geography has to shape provision. If we take a one-size-fits-all approach to healthcare delivery, it will only be half as effective for coastal communities. A strategy that pulls together all parts of government that have an impact on and interest in tackling coastal health inequality is important to bring together the action necessary to face up to this challenge. This speaks to the core of my vision for a country that works for people, to rewire Westminster around the lives that people lead. A patient misses an appointment because there is no bus. Their health deteriorates because their home is damp. They cannot get the help that they need because the local service cannot recruit. Westminster files those problems under different Departments, but that person experiences one life. We should organise government around that life. We should give people responsibility for the outcome, the resources to deliver it and the funding and authority to work meaningfully across Departments, not just within annual budgets. Tackling coastal health inequality is a great opportunity to show that this can work. This Bill does not list exhaustively all the things that the strategy should do, but it does touch on many of the key issues that Professor Whitty identified and that I and my constituents see and live with every day. The strategy would look at the recruitment and retention challenges of coastal communities, which come from being at the end of the line and lead to an extreme workload for those who do healthcare work in our areas. The chief medical officer’s report outlined how there are 14.6% fewer postgraduate medical trainees, 15% fewer consultants and 7.4% fewer nurses per patient in coastal communities. I have seen this at first hand in my area when it comes to securing enough trained pharmacists to keep community pharmacies open and operating in our coastal towns. Many will remember the scandal of the failure of Jhoots. It was noticeable how many coastal towns were impacted by that collapse. The localised factors of transport, environment, employment and more would also be addressed in this strategy. When seeking to address health inequalities, the Government need to truly understand how being coastal affects Cromer and Sheringham differently from Whitby or Grimsby. There are different characteristics of the coast—fishing, ports, tourism, rurality—and all need their solutions to be well tailored. To that end, I strongly encourage them to take a look at the excellent work of the Coastal Navigators’ Network, which has been taking on this great challenge and building a nationwide network of local government and health professionals to find solutions to challenges faced by coastal communities through the lens of opportunity. They understand how that investment, and the time and energy that is spent getting to the root causes of much of coastal inequality and deprivation, can pay excellent dividends in both wellbeing and economic terms. The test of the strategy will be what changes—how staff are recruited and retrained, how patients reach appointments, and how investment prevents ill health. Each commitment needs an owner, a timetable, and a measure of success. We cannot have this becoming another nice document that becomes confirmed to a fate similar to that of the “display department” in Douglas Adams’s “Hitchhikers Guide to the Galaxy,” meaning that we might find the coastal health strategy “in the bottom of a locked cabinet, stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard’.” Publishing a strategy is not the same as delivering it, and Ministers should return to the House and tell us what has improved, what has failed, and what they will change. When Chris Whitty was on our television screens every night, giving us evidence and making recommendations backed by data and in the public interest, the Government listened to him and trusted him. We listened to him and trusted him. There has been no change in his methods when assessing the challenges of coastal communities. His reasoning and recommendations are just as well thought out as during the pandemic. Coastal health inequality is another challenge of our times, and the data show that we are losing the battle. We cannot allow this approach of sidelining coastal issues, or assuming that they could be picked up by another non-specific piece of work as an afterthought. The coast is where the country begins for millions of people. It must not be where the Government’s ambition ends. Give this Bill its Second Reading, and make improving healthcare a responsibility that Ministers must answer for.
Madam Deputy Speaker (Ms Nusrat Ghani)Conservative
Colleagues know what time this debate has to end, so they should be mindful of time keeping.
Sadik Al-Hassan (North Somerset) (Lab)Labour
In my constituency, our coastal towns of Clevedon and Portishead are places of real character, with Clevedon’s grade I listed pier, Portishead’s maritime and dock heritage, and communities with a fierce sense of pride and belonging. As many Members of the House know, before I was elected I worked as a community pharmacist for nearly 20 years across the south-west. Behind the pharmacy counter I saw the health inequalities between coastal and inland communities first hand. The Chief Medical Officer’s report exemplifies that disparity. Five years ago, Chris Whitty warned that if health problems in coastal communities were not tackled vigorously and systematically, we would face “a long tail of preventable ill health.” It is a problem that will only get worse as populations age. That warning matters in North Somerset. Today, 11% of our population is over 75, but by 2043 that will rise to 14%. The 2021 census showed that people in coastal areas are more likely to report bad or very bad health. In Clevedon, 6.7% of people said that their day-to-day activities were limited a lot by their health, and the figure was 5.2% in Portishead. As the hon. Member for North Norfolk (Steff Aquarone) mentioned, coastal communities are harder to recruit in when it comes to health. My first-hand experience of trying to recruit pharmacists and health care professionals, such as pharmacy technicians and dispensers, across coastal communities in the south-west has shown me that it is problematic in those areas to get the healthcare professionals we need. That is also true of GP surgeries. The south-west has the highest community pharmacy vacancy rate at 14%, and workforce planning needs to reflect the ageing population in coastal communities, which will fuel the demand for healthcare. I hate to agree with the hon. Member one more time, but I believe the Government need to have a Minister specifically responsible for coastal communities, to push a cross-Government and cross-Department strategy to try to bring those inequalities in coastal communities closer to those of their inland neighbours. Transport and access to health hubs in coastal communities are more difficult, and that can be problematic not just for attending a GP appointment or getting to a pharmacy, but for getting to work for those working in a healthcare establishment. Pharmacy tends to map towards deprivation and health inequalities in this country, with higher numbers of pharmacies located where inequalities are greatest, and that links to coastal communities and rural areas. When pharmacy is impacted by funding cuts and closures, that tends to hit those communities worse, such as with the closure of the Jhoots pharmacies in Portishead. We lost two of the three pharmacies in that area, meaning that one pharmacy was left to serve a population of around 25,000. Thankfully, with the help of Magna Pharmacy, we have managed to reopen those two pharmacies, but closures make coastal communities particularly vulnerable due to the health inequalities.
I have put on the record my support for particular initiatives around coastal communities. Clause 4 of the Health Bill gives the Secretary of State a duty to have regard to reduce inequalities in access to health services for people in England. Does my hon. Friend agree that Ministers should be mindful of the needs of coastal communities when looking at that clause?
I agree with my hon. Friend’s wise intervention. As I have said, I would go further and put in place a Minister with a responsibility for coastal communities, so great are the health inequalities. They require such a focus. The 2021 report by Chris Whitty made several recommendations, and I urge the Government to take them forward. We need a cross-Government strategy for coastal health. We must ensure there are sufficient healthcare staff in coastal areas as recruitment levels are often lower than the national average, which, as I say, I have personal experience of. Finally, we must undertake better research. Coastal communities have been chronically understudied in public health research, and that gap leads to worse inequalities. An ageing population adds to pressures on local services, from getting appointments at GP surgeries to access to Pharmacy First at community pharmacies. I welcome the hon. Member for North Norfolk raising this issue. Someone’s postcode should never dictate their health outcomes, and I will continue to champion the health of North Somerset’s coastal communities today and for the years ahead.
Ian Roome (North Devon) (LD)Liberal Democrat
I greatly appreciate my hon. Friend the Member for North Norfolk (Steff Aquarone) for bringing forward this Bill on behalf of coastal communities around the country. Hundreds of families in North Devon have now spent three months without an operational maternity unit, and more than 200 births have been redirected over two hours inland to Exeter. It is not acceptable that an expectant mother in coastal towns such as Ilfracombe, Combe Martin or Lynton should have to travel so far to reach a hospital. It clearly amounts to a massive inequality in NHS healthcare. Many of my constituents feel that if this crisis had struck in Exeter, Bristol or London, things would be very different. We would not have just warm words of sympathy from the Prime Minister and the Secretary of State; we would already have a solution. Many women have told me that the anxiety and worry that the travelling time has caused them is not acceptable and that it has caused many families to feel that the worst could happen while travelling, especially because our areas have a heavy volume of tourists and the roads are narrow.
Ben Maguire (North Cornwall) (LD)Liberal Democrat
My hon. Friend is making a fantastic speech. I pay tribute to him for all his hard work campaigning on North Devon district hospital; it is a national disgrace that we have not seen its maternity unit reopen. Does he agree that in areas like both our constituencies, poor rural transport is locking our constituents out of accessing healthcare? In North Cornwall, not a single town has a direct bus to a major hospital, which I find incredible in 2026.
I thank my hon. Friend for making that point, and I totally agree. People in some areas of my constituency and my hon. Friend’s constituency use the hospital situated in my constituency, and it causes those families lots of worry. I appreciate all the work he is doing to help me on this campaign to get the maternity unit reopened. Many of these coastal towns have only very basic healthcare provision locally, and that is reflected in people’s quality of life and life chances. Coastal healthcare is a crisis that overlaps with poor housing, few economic opportunities, limited transport, as we have just heard, and other disadvantages. In one part of Ilfracombe, life expectancy is a full 10 years lower than in other parts of Devon. This Bill rightly says that the Secretary of State should be made to come to this Chamber and account for those disparities. Coastal towns have so much to offer, but across the country there is a pattern of too many coastal towns ending up in the category of “have nots”. A national strategy should exist to counter that and to deliver good healthcare for every coastal community. First-time parents in my constituency have been left all at sea. The Government must take this Bill seriously.
I thank the hon. Member for North Norfolk (Steff Aquarone) for introducing this Bill and, importantly, for shining a light on issues that deserve far greater attention. Our coastal communities are special places, but we know that many face challenges that can have a profound impact on people’s health, wellbeing and, indeed, life expectancy. Deprivation, low wages, poor housing, poor air quality, education opportunities and isolation all play a part. I want to concentrate on one area where these inequalities are particularly concerning, which is mental health. Research shows that young people in England’s coastal towns are three times more likely to experience a mental health condition. Behind that statistic are young people, families desperate for support and people whose conditions worsen because help simply is not available when they need it. These challenges are very real in my constituency of Portsmouth—a coastal city. Too many people in our city are struggling with their mental health. An estimated 15.4% of adults have been diagnosed with depression—above the regional and national average. Behind the figures are people trying to cope, families worried about loved ones and individuals who are not able to get the help they need. Getting this help is also not easy, because Portsmouth has 2,133 patients for every GP, compared with 1,634 nationally. This puts enormous pressure on primary care and makes it hard for people to access support early, when it can make the greatest difference. The picture for children’s mental health is equally concerning. The Hampshire and the Isle of Wight integrated care board spends just £966 per child with an active referral to mental health services—the 10th lowest spend in England. By comparison, north-west London spends £2,410. Even more troubling is that 40% of referrals are closed before a second contact—the third highest rate in the country. These are not figures; they represent children and young people who need someone to listen, families looking for reassurance and people who deserve consistent support, rather than being left to navigate the system alone. I therefore welcome the Government’s commitment to opening 159 new NHS mental health facilities across England, bringing support closer to home and intervening early, because it can make a real difference. When community support is unavailable, people too often experience a mental health crisis and end up in A&E. Our emergency staff do extraordinary work, but A&E cannot replace the specialist ongoing care that people need. We must give people access to the right support in the right place at the right time. That is why I am disappointed that Portsmouth has not been selected for one of these new facilities. Given the level of need in my city, I believe that Portsmouth should have been considered, and I welcome the opportunity to work with the Minister to see how we can make that happen. Behind all these figures are real people and real families. Too many young people, in particular, have lost their life to suicide in Portsmouth. I want to pay tribute to Tegan Hide and everyone involved in the Glade’s law campaign. I thank them for meeting me and sharing their friend’s story. Their determination to honour Glade’s legacy and improve mental health support in our city deserves recognition. Glade Clarke was a 23-year-old woman who sadly died of suicide on 26 August 2026. If we are serious about tackling health inequalities, we must recognise that coastal communities have distinct needs and ensure that they are not left behind. People in my city of Portsmouth deserve the right to access the same timely, high-quality mental healthcare as everyone else in the country, and I hope that this Government will continue to work with local communities like mine to make that a reality.
Steve Darling (Torbay) (LD)Liberal Democrat
Torbay is often known as the English riviera, and in my view, it is the premier resort in the United Kingdom. We have incredible beaches, incredible countryside and an outstanding hospitality offer. However, behind the beach huts and the palm trees, we have high levels of deprivation—in fact, Torbay has the highest level of deprivation of any constituency that has a Liberal Democrat MP. I pay tribute to Lincoln Sargeant, who is our director of public health. He was also in that role at the time of the Chris Whitty report, and he wrote a chapter on Torbay. I was leader of the council at the time that it was written, so I am only too aware of the issues, and had conversations with him about the deaths and about the diseases of despair that plague our communities across Torbay, whether they relate to drugs, alcohol or depression. Only this morning, I was speaking to a lady in Torbay who attempted suicide because of the challenges in her world, and was trying to support her. I would also like to mention Kate Lissett, the chief medical officer at Torbay hospital. She has shared with me how many patients who come into Torbay hospital say that they see living into their 60s as a good age in Torbay, which is shocking. The challenges we face include high levels of morbidity due to respiratory issues and—going to the other end of the spectrum—obesity and high levels of teeth extraction among young children. All these things in Torbay paint a very depressing picture. What is the fabric that gives rise to these challenges? It is that we have only 8% social rented housing, compared with a national average of 17%; when Thatcher came into power, the figure for the nation was 35%. As a young Liberal, many years ago, I campaigned on street homelessness, and the sad thing is that the levels of street-attached are worse than ever. In Torbay, we also have the third lowest household incomes in the country in terms of wages. I congratulate my hon. Friend the Member for North Norfolk (Steff Aquarone) on bringing forward the Bill. If we do not measure health inequalities in coastal communities and develop strategies, we are not going to tackle them.
Adam Thompson (Erewash) (Lab)Labour
I thank the hon. Member for North Norfolk (Steff Aquarone) for bringing this discussion to the Chamber. He might be asking why, as an inland MP, I am speaking on this Bill—I intend to cover that in the coming minutes. Before I begin, though, I will say that it was lovely to hear from the hon. Member for North Devon (Ian Roome). He reminded me of a holiday I had in his constituency many years ago, which I had more or less forgotten, so it was lovely to be reminded of the weekend I spent in Ilfracombe. I strongly respect the goals of the Bill, but I cannot directly support it. I do not believe that the problems the Bill diagnoses and seeks to recognise are limited to coastal communities, which is why I have chosen to speak today. The issues covered in the Bill and as part of this discussion are ones that affect communities up and down the country, whether they are next to the sea or—like mine—many miles from it. It is not living on the coast that inflicts particular problems on a place; it is people and economy. However, because of the fundamental imbalances that have plagued our country for decades, it is difficult for me to read that a specific strategy is needed to tackle child poverty in coastal communities. My community is nowhere near the sea, but there are children in poverty in Erewash who desperately need help all the same. Half of all the children in Ilkeston live in low-income households—that is nearly double the national figure. Opportunity needs to be created for young people right across the country.
I thank my hon. Friend for mentioning young people. This Government have changed the rules for parents on universal credit; previously, if their child went to college, they would still get universal credit payments. This Government have extended that to young people taking up apprenticeships. Does my hon. Friend agree that is a really helpful way to encourage growth and provide opportunities in deprived areas?
I completely agree. The work that the Government are doing to support young people— especially those not in education, employment or training—is really important. We are doing a huge amount of good in that space. Support should be offered—that is absolutely correct—but on the basis of need, not just geographical location. Why should concerns about poor educational attainment in coastal communities be recognised in law but not the real concern of parents in Erewash about poor school standards where they live? The thing is, basically everywhere in this country has some claim or another to having been left behind. Erewash is, given certain elections and a party politics-focused perspective, an extremely important place. Since my constituency was established in 1983, it has had a Government MP, completely without fail. I am proud to be the most recent in a very long line of Erewash Government MPs.
Maria Eagle (Liverpool Garston) (Lab)Labour
On a point of order, Madam Deputy Speaker. May I ask you to clarify that we are discussing the Coastal Communities (Health) Bill at Second Reading rather than the Debt Relief (Developing Countries) Bill, so that it is clear to everybody that we have not suddenly switched to the fifth Bill of the day instead of the third?
The right hon. Member is very Eagle-eyed. [ Laughter. ] She is indeed correct; we will rectify the error on the screens. We are indeed in the correct debate and hearing the correct speech.
I thank my right hon. Friend for making that point of order. I was just talking about being the last in a long line of Government MPs. In 2024, the then Prime Minister, the right hon. Member for Richmond and Northallerton (Rishi Sunak), launched the Conservatives’ 2024 election campaign in Ilkeston, where he took some planted questions from local Conservative councillors dressed in hi-vis jackets—that definitely made them look like ordinary members of the public—and the current Prime Minister kicked off his August listening tour in Ilkeston as well. As per the accounts of one Peter Thorne—one of my fantastic former local members, sadly now passed—even Clement Attlee once stood on a soapbox in Long Eaton market place. Indeed, many Labour party and Conservative party leaders have done so over the intervening years. Has Erewash’s status as a perennial key marginal done it any great service? Sure. Long Eaton was in the first round of levelling-up funding under the previous Government, but Ilkeston got rejected in the second round. The particular formulation of my constituency and its demographics mean that it has never been described as part of the “red wall”, but parts of it—especially Ilkeston—can really be considered as such. Ironmaking at Stanton—one of the smaller parts of my constituency—started at the dawn of the industrial revolution, and it carried on for more than 200 years, but sadly it did not survive beyond 20 years after it was privatised. A deep point of pain for my constituents is what happened in Stanton after it was privatised. I have spoken plenty of times in this place about the struggles that our town centres face. The high street banks are abandoning Ilkeston and Long Eaton, without any regard for the one in five people in my community— often elderly and disabled folks—who still do not use online banking and probably never will. Historic industries have left our towns. That is all as true in the midlands as it is on the coasts of Lincolnshire, Yorkshire, Essex, Kent, Dorset and Cornwall—wherever. It is just as true inland as on the coast. I accept that Erewash is almost as far from the sea as it is possible to be in England—I understand that the furthest point away is about 7 miles away from my house, so that is pretty close—but it is not like we do not also have the flooding issues that face our coastal communities. My constituency is bounded to the east by the River Erewash and to the south by the Trent, which is fed by the Derwent. That means that the entirety of my constituency—particularly Long Eaton—is always at flood risk, as I am reminded every year when I struggle to get house insurance. Even before I was a Member of Parliament, when Storm Babet came in 2023, I spoke to people across the constituency in Ilkeston, Long Eaton and especially Sandiacre, where many residents found their homes under water, facing exactly the same issues as their counterparts in coastal constituencies. A few months ago, I was joined by my hon. Friend the Minister of State for Water and Flooding at the new Witches Oak addition to the Severn Trent site at Church Wilne, which is being specifically developed to deal with particularly dirty water sourced from the River Trent. The River Erewash itself, formerly flanked on both sides by heavy industry, as it flowed through Mansfield, Ashfield, Amber Valley, Ilkeston and Long Eaton, was once said to be the most polluted river in Britain. I was particularly bemused by attitudes to regional development and the distribution of economic growth during the Makerfield by-election. Right-wing journalists, perhaps for the first time ever, were looking at ward-level economic data to try to say that the incredible growth they have had in Greater Manchester was all just bundled up in shiny towers in the city centre, but that is not what the evidence showed. That suggests that columnists at The Spectator and The Daily Telegraph were perhaps not engaging with that very real and serious debate in good faith. While the pinnacle of growth in Greater Manchester may not yet have reached to the very edges of the metropolitan area, it has spread outwards into Salford, Trafford and Stockport. What does that tell us about economic growth in the country, in coastal communities and in my community? It is quite simple, really. Some have observed that maps of economic growth across the country just show us where trams go, where local train stations serve or where bus routes go. That should not be a surprise to us in the east midlands or in our coastal regions; Nottingham has a great tram network, and the city has a more productive economy than the country as a whole. I know that they have done incredible work in Stockport on densification, meaning that there are more people in the same space living together, shopping and socialising, and therefore doing a greater amount of economic activity. I will return to my central thesis. We have grievous economic inequalities around the country, be it in coastal communities or in towns. As we all know, regional distribution is exceptionally poor. I met an education YouTuber—a woman called UnJaded Jade—at Labour party conference this year, and she drew my attention to some of the statistics. They are the things that we know in abstract and by instinct, but it is shocking when they are laid out in front of us. More than half of all graduates from the top universities are still from London and the greater south-east. Young people in the midlands are the least likely to go to university to study a creative subject. When I see communities in England that are really moving, getting along and growing, they are down here in London and in Manchester, where there is a clear, significant space for creative industries, which need graduates in creative subjects to fuel them. The truth is that that is a world away from our economy in the midlands, where there is very little opportunity for jobs in the creative industries and young people are thoroughly discouraged from pursuing one, despite their growing and innovative part in the British economy overall.
I thank my hon. Friend for considering our children, our young people and their opportunities. Does he agree that the report by the Children’s Commissioner made for some very stark reading? My own city of Portsmouth was the 12th-worst place in the country to be a child, yet Hampshire was in the top 20 best places. When we talk about red wall seats and areas of deprivation, it is really important that the south-east is not just seen as one block; there are elements of high deprivation in the south-east. We were the worst place in the country for opportunities for 16-year-olds.
Order. Before the hon. Member for Erewash (Adam Thompson) returns to his speech, let me remind him that we are debating the Coastal Communities (Health) Bill, which is about health inequalities.
Thank you, Madam Deputy Speaker. I will continue to make points about the health system in coastal communities. I thank my hon. Friend the Member for Portsmouth North (Amanda Martin) for her intervention. The fact is that coastal communities have suffered for the same reason that the post-industrial midlands and north have: the economy has changed, and the health provision has changed with it. A good part of that change is the swirling nature of markets, consumer interests and all that, but undeniably political choices were made. The route to recovery for those places, whether we live next to the sea or far away from it, is economic growth. That is as true in the health space as it is everywhere else. For that, we need investment. I have no doubt that a great many of our coastal communities suffer from infrequent, expensive and unreliable deregulated services, particularly in the health sector, that have been cut time and time again. There is a lot more that I could talk about, and I know that the various crises are really biting in many coastal communities, but I want to end my speech by saying that I cannot support the Bill as written, because I agree with the Prime Minister. What we need is growth in every postcode, in the health sector and across all of society. Our problems are not created by geography, even if they are reinforced by it. Ultimately, the problem is that our economy and our health service have been imbalanced for too long. Regardless of whether someone is on the North sea, looks out across the channel or, like me, lives in the very heart of the midlands, where they live has been left behind because of political and ideological choices made by successive Governments. I am proud to be part of a Government who recognise that fact and are finally striving to correct our nation’s course—not pitting us against one another, but pulling us all together.
The Minister for Social Care and Mental Health (Alison McGovern)Labour
I begin by thanking the hon. Member for North Norfolk (Steff Aquarone) for bringing forward this Bill and for giving the House the opportunity to debate, on all sides of the question, the health and wellbeing of our coastal communities. I trust that the hon. Member will be reassured that, as a Minister and a constituency MP for Birkenhead who lives right next to the edge of the country, on the banks of the River Mersey and proximate to the Irish sea, I understand this issue very well. The Government share the concern that lies behind this Bill. We recognise that there are significant and persistent health inequalities in some of our coastal communities, and it is absolutely right that the Government address them. However, having listened to the debate, I am struck by some of the comments that my hon. Friends made about the various health inequalities that persist across our country. I agree with my hon. Friend the Member for Erewash (Adam Thompson) that the underlying economic circumstances are the determinants of health. There should be nothing inevitable about somebody experiencing poorer health, or spending fewer years of their life in good health, simply because of where they live, yet in far too many communities, including coastal communities, poorer health outcomes sit alongside deep-rooted social and economic disadvantage. These challenges are not new. They were set out powerfully in the chief medical officer’s 2021 report on health in coastal communities, and the importance of place to our health has been reinforced by the chief medical officer’s latest annual report on health in rural areas and small towns. We in this House all thank the chief medical officer for his considerable work on this subject. That report is particularly relevant to today’s debate, because rural, small town and coastal communities frequently overlap, and many of the challenges that it identifies will be familiar to Members of this place. It highlights the challenges of accessing and providing services across greater distances, limited public transport, ageing populations, workforce recruitment and retention, housing pressures and hidden deprivation. Importantly, the report also emphasises that health and social care services need to be designed around the needs and circumstances of local populations. That matters, because when we talk about health inequalities, we cannot simply talk about differences in people’s experience of the NHS, as I said yesterday in a speech on the work that we are doing on social care.
Given that we have limited time for a full ministerial response and that the Minister obviously has an interest in this subject, as do I, will she agree to meet me or set up a meeting with the relevant Minister to discuss coastal health inequalities further?
As you know, Madam Deputy Speaker, I never refuse a meeting with any Member of this House. I have my surgeries on Wednesdays, if the hon. Member would like to pop in and talk about mental health or social care. If he wants to talk about general health inequalities, I refer him to the Minister for Public Health and Patient Safety. Of course, high-quality healthcare matters enormously to all of us. Our health is shaped long before we arrive at a GP surgery or a hospital waiting room. It is shaped by the homes in which we grow up and live, by our education and the opportunities available to us, and, as Labour Members know only too well, by whether we have secure and rewarding work. Our health is also shaped by our income, by the transport available to us, by our environment, and by whether the communities in which we live give people the opportunity to lead healthy and fulfilling lives. Place and geography matter for health, but tackling inequalities between places requires action within healthcare and far beyond it. That is an analysis with which this Government agree, and I have not heard dissenting opinion in the House this afternoon.
The debate stood adjourned (Standing Order No. 11(2)).
Ordered, That the debate be resumed on Friday 5 February.
Source: UK Parliament Hansard API. Debate ID: 5437016.