NHS Funding: South-west

I beg to move,

That this House has considered NHS funding in the South West.

It is a pleasure to serve under your chairmanship, Dr Huq. For me, the NHS is a family affair, as my wife has served it for more decades than she would want me to admit and my son is a registrar at Torbay hospital.

This time last year, many of us were out pounding the streets at the general election, and the NHS was a big plank of what many of us talked about. It was one of the key themes on which the Liberal Democrats fought the election. We knew the NHS was a shambles, but we did not know the challenge that would face the new Government when they came to power. The Minister for Care highlighted that the money for the new hospital programme ran out in the March just gone, and there was a £6.6 billion hole in the programme’s budget. It was a real challenge for the new Government, but equally, their “waves” approach has caused real concerns in hospitals across the south-west and in our communities. It would be extremely helpful if the Minister for Secondary Care could address that today.

I will focus on Torbay hospital as a useful example of the challenges we face across the south-west. It is the third oldest hospital in the UK, with only 6% of the estate up to standard. Some bits are very good, such as the endoscopy and out-patient units, but those constitute an extremely small proportion. Someone suffering from cancer has to go to a number of locations across the hospital where there are real challenges. That is not the offer we want for those suffering from that disease. There have been almost 700 sewage leaks on the site, often infecting clinical areas, resulting in closures and delays of service to our community. The tower block of the hospital is swathed in scaffolding—not for a rebuild, but to stop clumps of it falling off and braining passers-by. There are some massive challenges, which have impacted our world.

Wave 2 mitigation bids went in in February from affected trusts. Torbay bid for £183 million to collapse the tower block and ensure that we have four fit-for-purpose wards built. I understand that the white smoke from the Government is yet to appear. So far, we have had only £7 million to help tackle some of the challenges, which hardly touches the sides.

I congratulate my hon. Friend on bringing the NHS in the south-west into the spotlight. Does he agree that the pressures on Musgrove Park hospital, due to the closure of the Yeovil maternity unit, put staff in an almost impossible position, with 30° heat in summer and leaking roofs and walls with holes in them in winter?

I agree that staff are the NHS’s most important asset and what makes it tick, which my hon. Friend is right to highlight.

I am here to support the hon. Gentleman; I congratulate him on bringing this subject forward for debate. He is right to highlight issues with cancer care. It is the same for us back home: only a third of those referred by GPs begin treatment within the target time. Does he feel that there is money to be saved through the administration in the south-west trust area? If there is, perhaps that could help.

That is very insightful. After being around medics for many years, I know the concern about the increase in managers. Equally, I know that integrated care boards, which I will come on to now, have real challenges with the savings that they are making. There is talk of merging ICBs, including, in the far south-west, a merger in Cornwall and Devon. Both ICBs are relatively challenged, and I fear that it could be a marriage of two bankrupts. Perhaps it would be better to look at a bigger footprint, including Somerset.

I welcome and echo the hon. Member’s comment about an inappropriate marriage in respect of the Devon and Cornwall ICBs. They have quite different issues. I commend the work of Cornwall’s ICB, of course, but we have to recognise the specificities of the peninsula penalty and the unique challenges facing both our areas.

That is also very insightful. There are lots of good staff throughout the NHS, including in ICBs. It is about unlocking their potential, which I hope the Minister can do.

I was suggesting a bigger footprint, which could include Somerset and maybe even Dorset, as well as Devon and Cornwall, to give greater corporate capacity. I hope the Minister will reflect on that. Perhaps she will give some guidance on when we will hear about the ICB merger. A larger ICB could reflect the footprint of a mayoral authority; I fear that we could be poorer country cousins if we have only two county mayors in the west of England.

The real challenge with our ICB is that we are looking at a quarter of a billion pounds in cuts to services for Devon. The Exeter trust faces £69 million in cuts. The way to save money is mostly by not filling posts, so that is a real challenge. In Torbay, the figure is £42 million. We have an integrated care organisation, as a result of the merger of NHS acute and social care services, and people often say that is the direction in which we should be going. It saves 60 beds in the hospital by ensuring that we get people out of hospital sooner and into their own homes, where they want to be. However, I worry that the organisation is threatened by the quarter of a billion pounds-worth of cuts to services in Devon coming down the line; I fear for its future. I know that the Government actually want to move in the direction of services working together—it is so important.

The last area I want to touch on is Getting It Right First Time. I have heard from a number of professional sources that they feel that is a metropolitan approach that does not always work well in areas with significant rurality, such as Devon, mostly because it does not take into account some of the deprivation we have, our coastal communities, rural communities and the need for travel, or the fact that our population is older than those in metropolitan areas. We have older folk who are perhaps more digitally excluded. The approach does not always work.

Order. Given how many people wish to speak, we will start with a two and a half minute limit.

I was not expecting to be called first, but thank you very much, Dr Huq.

Each year, Cornwall, which has a population of 650,000, welcomes around 4 million visitors, drawn by our beautiful beaches and coastline. Tourism is a key part of our economy and provides a livelihood for many, but the downside is the pressure on our public services. Some areas in Cornwall treble in population, and that has a profound impact on our NHS and our only hospital, the Royal Cornwall hospital in my constituency.

In 2021, our hospital was on black alert all summer, and 30% of those attending A&E were not registered with a Cornish GP; the August bank holiday saw almost 700 people go to the emergency department. Hospitals in other parts of the country tend to see reduced pressure in the summer, but the Royal Cornwall is under pressure all year—winter and summer. We also have a super-ageing population—that is not my term, but the NHS’s—because many pensioners choose to retire down in Cornwall.

The current health funding formula does not reflect that seasonal reality or sufficiently account for factors such as population sparsity, rurality or poor transport links, all of which make healthcare much more expensive to provide and all of which affect Cornwall. Our health services are therefore very much overstretched.

The South Western Ambulance Service is the worst-performing ambulance trust in England, and its performance is worst in Cornwall. An April 2025 SWAS performance report showed that Cornwall had the worst category 1 mean response time—nearly 11 minutes, compared with the national target of seven minutes. It is the same for category 2, and the handover time is high as well.

Those ambulance delays have serious consequences. We have ambulances waiting outside our hospital, and in December 2023 two of our coroners wrote to the Secretary of State with a concern about avoidable deaths as a result. They were keen to stress that the challenges are systemic; they are not the fault of the trusts, and they are too big for a single doctor, nurse or paramedic to fix, and too big for the hospital trust or ambulance trust to fix on its own.

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Torbay (Steve Darling) for securing this debate.

I am here to focus specifically on fertility treatment in Devon, which is one of the costs we have because of the atrocious funding situation to which the hon. Member referred. The Devon integrated care board is not currently funding fertility care for local patients in line with Department of Health and Social Care expectations, and is not following National Institute for Health and Care Excellence guidelines in their entirety. Its policy is not based entirely on the clinical factors recommended by NICE, but is based instead on previous clinical commissioning group policy, economic factors and additional non-clinical factors, which are all understandable, but that is not good enough for local patients.

NICE states:

“Commissioners…should commission sufficient capacity within specialist fertility services to provide 3 full cycles…for women aged under 40 years who meet the criteria for IVF…A full cycle should include 1 episode of ovarian stimulation and the transfer of any resultant fresh and frozen embryo(s)”,

and that any previous cycle counts towards that total. NICE guidelines also state that women under 40 who meet the criteria for IVF treatment

“should be offered 3 full cycles of IVF”

with a cycle defined as including one episode, as I have said. A full cycle ends either when every available but viable embryo has been transferred, or when one results in a pregnancy.

Devon ICB incompletely funds only a portion of one cycle. It has made up a different definition of a cycle, and, in the commissioning policy, defines a cycle as

“one…fresh and one…frozen implantation of embryos. A frozen embryo transfer episode will only be available if there are embryos generated from the fresh cycle suitable for freezing.”

In less than a year, this Government have recruited 1,700 new GPs, delivered 3.5 million new appointments and cut waiting lists by more than 200,000. Just today, we heard in the Chamber the good news from the spending review: a record cash investment increase, in real terms, of 3% every year up to 2029, the equivalent of £29 billion extra a year. That will help to put our NHS back on the road to recovery.

In Dorset, we are already seeing the impacts of the investment. Dorset ICB has seen 13,600 extra urgent dental appointments. The public health grant for Bournemouth, Christchurch and Poole council is up from £22 million in 2024-25 to £23.3 million in 2025-26. There have been four surgeries identified for enhancement in Bournemouth, one of which is in my constituency, and the waiting list for University Hospitals Dorset trust is down by 1,715 between July and now.

I thank my hon. Friend for giving way, and for setting out so clearly the work this Labour Government are doing to fix our NHS. Will he take the opportunity to welcome the investment of some £100 million being delivered by this Labour Government that will totally rebuild the emergency department and critical care unit at Dorset county hospital? Does he share my belief that fixing the front door of our national health service is essential for driving down waiting lists in Dorset?

My hon. Friend makes a powerful point. I, of course, welcome that investment and it will benefit both his constituents and mine.

We are also seeing significant investments in the Royal Bournemouth hospital. Just yesterday, I was standing on top of the Coast building at the hospital, at the topping-out ceremony. The Coast building will feature 110 new beds across four floors, a larger kitchen and a catering facility. If we look across from the top of that building, we will see the new £91 million Beach building that houses the emergency department from the Royal Bournemouth. Services moved into that building in May, and it will also contain a maternity unit, critical care and a children’s unit, which will be moving in next year.

These developments are all part of a £500 million transformation of University Hospitals Dorset sites, which is much needed and will have a critical impact. These investments across hospitals, and across Dorset, will improve care for the people of our region—for my constituents—and will support our staff, who have been really looking for light at the end of the tunnel after 14 difficult years of Conservative rule, so that they can care for patients in modern, purpose-built facilities.

I would like more. Despite all the investment and the upcoming reform, I would like the funding formula to be changed so that it reflects the age profile of our local area. The south-west and especially areas such as BCP have a much higher older population, but not the funding to match. Our house prices are high but, unlike in Hampshire, UHD staff do not get pay weighting. I would also like to register concerns about proposals to create new subsidiary companies in Dorset and Newcastle. I have called for a pause in those processes, because I have concerns about the terms and conditions. Existing staff who are TUPE-ed into a subco have their existing terms and conditions protected, but I am concerned that when new staff are recruited into subcos, they do not have existing NHS terms and conditions. That could particularly affect lower-paid roles.