Westminster Hall

Tuesday 16 June 2026

[Sir Jeremy Wright in the Chair]

I beg to move, That this House has considered community hospitals.

It is a pleasure to serve under your chairship, Sir Jeremy, and I am grateful to have secured this debate. I want to begin by thanking Jo Posnette and Dr Helen Tucker from the Community Hospitals Association, who have been an enormous help in preparing for the debate. I welcome Jo, who is in the Gallery.

Last year, according to the Royal College of Emergency Medicine, around 15,860 patients died in NHS A&E departments in England while waiting for care that could have saved them. That is roughly 1,300 people every month—nearly 10 times the figure recorded in 2015. Every week, more than 300 people died a preventable death simply because they waited too long. Those numbers are shocking, but behind every number there is a real life tragedy. Let us remember that human aspect throughout the debate.

I am sure I do not need to point out to colleagues that in rural areas the situation is often even more challenging. The ambulance takes longer to reach people, the journey to A&E is longer and, when services at a community hospital have been reduced to a limited number, as is currently happening in my constituency, there might be no early safety net to catch the patient before a crisis becomes a catastrophe.

I thank my hon. Friend for her passionate speech about community hospitals. In my constituency we have a fantastic community hospital with a minor injuries unit, but the unit is open only on Tuesdays, Wednesdays and Thursdays, with reduced hours. It could treat thousands more patients each year. Does my hon. Friend agree that opening minor injuries units for extended hours would help to relieve pressure on A&E departments in acute hospitals?

My hon. Friend makes a good point. Not everybody can time their minor injuries to fall conveniently within the unit’s opening hours, so I absolutely sympathise with the challenge facing her local hospital.

I commend the hon. Lady for securing this important debate. I apologise to her and to you, Sir Jeremy, for not being able to stay; unfortunately, I have to be somewhere at 10 o’clock that is about 10 miles away. Like the hon. Lady, I wish to shine a light on the quiet heroes of our health service: our community hospitals. Places like Ards community hospital in my constituency are not just buildings but the bedrock of local care. They are the vital bridge between the high tech intensity of a major acute hospital and the sanctuary of a patient’s own home. I support the hon. Lady in making the case for community hospitals, because my community hospital does all the things she wants community hospitals to do across this great United Kingdom of Great Britain and Northern Ireland.

I thank the hon. Gentleman for his perceptive intervention. Community hospitals often do feel more like a home from home. They are more accessible for a patient’s friends and family to visit, and they deliver better outcomes for patients and clinicians alike.

In the south west, ambulance handovers at acute hospitals took more than 30 minutes in more than half of cases in January 2025—nearly 30% above the England average. A few months ago, I had the privilege to ride in an ambulance for a day. In what ended up being a 13-hour shift we attended only three call outs. Maybe it was a quiet day—I am definitely not saying I wish there had been more grief out there—but we spent much of the day on the road and/or waiting outside hospitals, which did not seem the best use of a highly qualified ambulance crew and an expensive resource.

It will not be news to anybody in this room that our NHS is under pressure, yet, against the odds, community hospitals continue to perform. The Care Quality Commission reports that between 75% and 92% of community hospitals are rated good or outstanding, which is remarkable given that the number of district nurses working in them fell by around 55% between 2009 and 2024, with underinvestment and the loss of EU staff after Brexit cited as key causes.

I recently met the chief executive officer of the newly combined Surrey and Sussex integrated care board, and urged her to consider the potential for expanding Horsham community hospital on Hurst Road into a neighbourhood hub, including a women’s health unit, to mitigate the lack of a general hospital in the area. Sadly, her first task has been to reduce her staff by more than half. Does my hon. Friend wonder, like me, what happened to the extra £29 billion that the Government invested into the NHS? It does not seem to have got anywhere near Horsham.

That is a very good question that I hope the Minister will be able to answer. I pay tribute to the absolute heroism of the people who staff our community hospitals; they are delivering an incredible return on investment.

I have had loads of emails from staff who were worried that Crewkerne community hospital was shutting down, because the communication from local NHS leaders has not been good enough—a problem we also had with the maternity unit. Does my hon. Friend agree that communication from NHS leaders needs to be a lot better?

I absolutely agree that a lot of the frustration felt on the frontline is due to lack of clarity of communication. Community hospitals are institutions, and I pay tribute to the people who work at them, who do more with less, year after year. They deserve better than for services to be quietly wound down.

I invite Members to imagine for a moment that they are 80 years old—it is less of a feat of imagination for some of us than for others—and living in a village outside Cirencester. Maybe they can no longer drive due to poor eyesight. They wake up one morning with chest pain. There is a hospital in town, but the services have dwindled one by one: no A&E, acute ward or surgery, and the theatre may be currently paused. What is actually needed—prompt assessment, a bed close to home and blood tests that do not require a 25-mile journey to Cheltenham on rural roads—may not be available. That is the reality for many people across my constituency right now, and it is getting worse.

Community hospitals have been an honoured part of our healthcare system for over 150 years. Research published in the Journal of Community Nursing in 2024 describes them as bridging “the gap between primary and secondary care.”

They are person centred, nurse led and multidisciplinary settings that help people to recover, maintain independence and enjoy visits from friends and family. They are not a quaint historical relic; they are precisely what the NHS says it wants more of.

The Cirencester community hospital was exactly that kind of place. Since the day surgery unit was suspended last year, I have heard so many moving stories from constituents, their fond memories of being in hospital, and how much that hospital, right at the heart of their community, meant to them when their children, parents or spouses were sick. But over the years the services there have been eroded one by one: first A&E, then acute wards, paediatrics, maternity and blood services. In 2025, the day surgery unit was paused as part of NHS Gloucestershire’s centres of excellence trial. Each change came with reassurances, but each one left residents further from care. My constituents have become deeply and rightly sceptical that a trial closure will ever be reversed.

The hon. Lady is making a powerful point about trust and promises being made but not delivered. Twenty years ago, Littlehampton hospital in my constituency closed, with the promise that a replacement health service would follow. In Rustington, there has been a lack of consultation and the hospital has closed; we are hoping it will reopen. Does the hon. Lady agree that consultation, trust and following through on promises are so important?

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.

My hon. Friend is very generous to give way again. In my Stratford on Avon constituency, the Ellen Badger community hospital in Shipston on Stour served the community for hundreds of years. The Coventry and Warwickshire integrated care board removed the in patient beds, which were really important in rehabilitating and looking after patients from acute settings before they went home. Those beds were close to their home. Does my hon. Friend agree that the Government must invest in care in community hospitals to relieve the pressure on acute settings?

I absolutely agree with my hon. Friend’s point. We need a more joined up approach. From conversations that I have had with nurses in my constituency, I know that those on the pointy end can see very clearly where the bottlenecks in the system are. We need to relieve the pressure on those bottlenecks.

I will conclude with five asks for the Minister. First, will the Government give a clear commitment to protect and properly resource Cirencester hospital as a local health hub, with the operating theatre restored, not paused indefinitely while the trial closure quietly becomes permanent?

Secondly, will the Government give a timeline, with dates, for the full restoration of maternity services in Gloucestershire, including post natal provision at Stroud?

Thirdly, will the Government give an honest account of how the shift from hospital to community will actually be delivered in rural areas? What oversight will there be? What protections are in place? What prevents the same pattern of managed reduction from continuing in the name of the 10-year plan?

Fourthly, will the Government commit to work with the Community Hospitals Association towards a national definition and dataset for community hospitals in England, so that our 500 community hospitals can finally be planned for, funded and properly valued?

Finally, will the Minister agree to a meeting? I would very much welcome the opportunity to sit down with her, alongside local NHS leaders and the Community Hospitals Association, to discuss the long term future of Cirencester hospital, its role and resourcing, and its place in the vision of care closer to home, which this Government say they believe in.

My constituents are not asking for anything exceptional. They just want to know that, if they get ill, there is somewhere to go that they can get to. The NHS was founded on that promise, and that promise must be kept.

Order. I thank the hon. Lady for opening the debate, and remind all Back Bench colleagues who wish to speak that they should continue to bob—not right now, but as the debate continues—so that I know they want to speak. I am hoping we can avoid any time limits this morning. We have five Back Benchers wishing to contribute, and if they limit themselves to about seven or eight minutes each, we should be fine.

I commend the hon. Member for South Cotswolds (Dr Savage) for securing this debate and for giving me the opportunity to talk about my experiences of the benefits and challenges of community and cottage hospitals. I do so in the knowledge that healthcare in Scotland is devolved and so is not under the purview of my hon. Friend the Minister.

Prior to my election to this place, I spent nearly 23 years working with volunteers in the health services in Lanarkshire, a job that was highly pressured, but also highly rewarding. An absolute highlight of my day or week was visiting the volunteers in either Kello hospital in Biggar, in the constituency of the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), or Kilsyth Victoria Memorial cottage hospital, in my constituency. This debate is timely, because it was in the day room at Kilsyth Victoria that I heard the horrific news of the murder of Jo Cox, 10 years ago today. Attempting to stay professional and encourage two new teenaged volunteers to have conversations with patients while trying to digest what I saw on the large screen less than 10 feet away will stay with me forever. I send my love to Jo’s family today.

Like many cottage hospitals, Kilsyth Victoria dates from before the NHS was created. In our case, the hospital was created by the local miners as a miners’ hospital in 1903; the part of the hospital that can be seen from the road dates back to that time. The main patient areas are within a more modern extension—I say “more modern”, but it is still older than me. The hospital now comprises a day room, a dining room where all patient who are able can have meals together, and a range of two bedded and four bedded bays, as was standard at a time when patients were not used to the space or the individual and ensuite rooms that are considered the norm and expectation today. The minor injuries unit disappeared in the days before covid, and the physiotherapy and out patient clinics have been moved to the health centre.

In the brief time that I have, I want to talk about how the benefits of hospital services in the heart of communities, which are often remote from big district general hospitals, are outweighed by the considerable challenges that they face. As times have changed, our expectations of healthcare have changed. When I started working at Kilsyth cottage hospital, the patients were all registered with Kilsyth general practitioners. It was unusual for patients not to be from Kilsyth; if they were not, they were from the neighbouring villages, Croy, Queenzieburn or Banton. The GPs knew the patients, and they provided medical care for the hospital. The staff were all generally local people themselves. Patients were admitted for intermediate, respite and end of life care.

My experience is that where hospitals have closed, it is because GP cover has been withdrawn. The GPs in Kilsyth still provide the medical care, but in reality it is nurse led care, with medical cover on the end of a telephone line or a video call, and which presumes good technological connections in a former mining village.

Do not get me wrong: I am a big fan of nurse led care. Registered nurses who work in community hospitals are highly skilled in the types of care that these patients need. It is heavy work, as patients need a lot of physical care, but it can also be isolating. On a night shift, there might be only one registered nurse in the hospital, which means no break on a 12-hour shift and, with many of these hospitals are miles away from assistance, they might not be able to get help from a registered nurse on another ward.

Patients are more likely to have a dementia diagnosis than 20 years ago, which means that the type of care provided has changed. It was in these hospitals that I learned how important it is to look at a patient’s feet: if they were wearing slippers, it probably meant that they were not meant to have their hat, coat and handbag and be on their way out of the door. Even having barriers with entrance codes did not manage to stop people, because they were all from the village, so they knew what the codes were—they did not forget those.

It can be difficult to recruit staff, who often have to travel long distances, because there is a lack of understanding of how rewarding it is to work in a cottage hospital in the middle of the community. However, what these hospitals provide is the epitome of care in the community. For those who are unable to look after themselves in their own home and who might be thinking about what it means to go into long stay care or to move into a care home, community hospitals provide that transitional step. They are much more than buildings; they meet a need at a difficult time in people’s lives, and they are absolutely vital.

It is an honour to serve with you in the Chair, Sir Jeremy. I am grateful to my hon. Friend the Member for South Cotswolds (Dr Savage) for providing us with this opportunity to talk about community hospitals. In particular, I pay tribute to the fantastic NHS staff who work across Devon. They pull off an incredible level of service in spite of the constraints they are working under.

In my constituency, we have five community hospitals across Axminster, Honiton, Ottery St Mary, Seaton and Sidmouth. Years ago, they all provided in patient beds, minor injuries units and rehabilitation services, acting as halfway houses after discharge from the acute hospital, which for us was the Royal Devon and Exeter hospital, and before home. They also provided support after operations, cared for the elderly and freed up beds in the RD&E and other acute hospitals.

Today, much of that capacity has been stripped away. Of those five community hospitals, only Sidmouth retains in patient beds—and a mere 25 at that. For a region of 150,000 people dealing with constant discharge pressure from Exeter, that is plainly insufficient. Honiton is the only one of the five that still has a minor injuries unit. I wrote to the new interim cluster chief exec for NHS Cornwall and NHS Devon two months ago to demand assurance that our community assets and services would remain safe from closures; it concerns me that, two months later, I have not had a reply.

I ask Members to imagine being an elderly resident in Axminster faced with a medical emergency. A constituent who came to see me at a surgery in Axminster was dreadfully worried about the discharge of her husband from the acute hospital, the RD&E, because she was so frail and elderly that she felt unable to look after her frail and elderly husband. Apart from anything else, she was absolutely distraught with worry about not being able to look after him. The nearest major hospital from Axminster is an hour away at Exeter, and the journey there through the countryside is not just inconvenient for people at that stage of life; it is unmanageable.

In preparation for this debate, I spoke with the president of the Community Hospitals Association, Dr David Seamark. David is not only president of the CHA but a constituent and a GP based in Honiton. He told me that community hospitals were designed precisely to face down these sorts of challenges. Community hospitals are embedded in rural and coastal areas, which is particularly good for older and more vulnerable populations. Across the UK, there are around 500 community hospitals, and many of them are located in these sorts of places, outside of cities and where access to centralised care is far more difficult.

This is not the stuff of romance. These are not leftover legacies from a bygone era, and they are not historical; they are well placed assets for this era. They are adaptable, thanks to their autonomy, and they are capable of delivering wide ranging, complex medical services. Our east Devon hospitals perform X rays, surgeries and diagnostics. Despite losing their in patient beds 10 years ago, they remain vital hubs of care for the local community.

We have seen proposals to close wings and services, and even to demolish facilities, as was the case in Seaton, where the local community understood what was at stake. It was impressive to hear about the petition that my hon. Friend the Member for South Cotswolds put together, which so many people signed in support of her community hospital. In Seaton, more than 9,000 people signed a petition to retain the community hospital there, and we had a public meeting in Colyford where people queued out the door to show their support.

These are cherished institutions, built on decades of trust and born from community investment. The chief medical officer, Professor Sir Chris Whitty, agreed when he spoke at the Community Hospitals Association’s annual conference last month. He echoed the words from his 2023 annual report, “Health in an Ageing Society”, which is well worth going back to, and said that ageing and the resulting increased frailty were key issues for the future of UK healthcare. He argued that community hospitals are in just the right places to be on the frontline and tackle this issue for generations to come in our rural and coastal communities, and described community hospitals as “an essential part of provision for both inpatient and outpatient care for many citizens in England and the wider UK.”

That clashes with the Government’s insistence that centralisation and the creation of large neighbourhood health centres will deliver progress and better outcomes. Neighbourhood health hubs are being exposed as a contradiction in terms. They misunderstand both geography and demography: geography, because they do not fit rural and coastal areas and suck resources into the nearby conurbations, and demography because, if the challenge facing our health service is an ageing population, solutions must be about proximity, accessibility and the continuity of care.

The choice is plain for all to see: do we continue down this path of centralisation—closing, cutting and consolidating—or do we build on what we already have and cherish? When Seaton hospital was built in the 1980s, people were told that they should be a brick and buy a brick. We need to build on that legacy. Community hospitals should not be sidelined; they should be strengthened. They should be the backbone of genuine neighbourhood healthcare, not displaced by some remote health hub that, in an Orwellian turn of phrase, is moved further away and deemed to be a “neighbourhood health hub”. If the Government are serious about delivering care closer to home, supporting our ageing population and relieving pressure on our hospitals, they must invest in, not abandon, our community hospitals.

I thank my hon. Friend the Member for South Cotswolds (Dr Savage) for giving us all the opportunity to shine a spotlight on the challenges facing community hospitals, particularly in rural areas. Neighbourhood health and care in the community are the thrust of this Government’s health strategy. That is admirable and right, but good intentions alone are not a health strategy, and intentions mean very little if the infrastructure to deliver them does not exist. In constituencies like Tiverton and Minehead, it increasingly does not.

Let us take, for example, the removal of the CT scanner from Minehead community hospital. I have been stopped in the street more times than I can count by constituents expressing how big a blow that has been. The whole point of a scanner in Minehead was proximity—for it to be accessible to people across west Somerset who face long journeys to reach secondary care. Its removal is therefore curious, and a direct contradiction of the Government’s stated commitment to bring care closer to people. The strategy says one thing and the decisions say another.

It is not hard to understand why we are where we are. West Somerset is, in effect, a cul de sac, with limited transport, limited infrastructure and a long schlep to Musgrove Park hospital in Taunton for most things approaching secondary services. That has consequences beyond access; we are not an easy posting for healthcare workers either, precisely because of the geographic reality. There are no meaningful incentives attracting people to train and practise there, and there is no laser focus on local recruitment efforts, which I believe is our best bet. We live in a beautiful part of the world—it is true—but why would a newly qualified clinician choose a remote, poorly connected posting when better resourced options exist elsewhere? The south west, as my colleagues know, is haemorrhaging healthcare capacity, and my constituency feels the effects acutely. Frankly, we are not being resourced as though those difficulties matter at all.

Every missed appointment is not just a missed check up; it is a missed diagnosis. When people cannot reach care, conditions worsen. Some will inevitably end up in A&E, placing further pressure on an already stretched urgent care system, in a region with one of the country’s least accessible healthcare networks. We end up paying more for failure, and the approach has not acknowledged that an ounce of prevention is worth a pound of cure. When we talk of community care, it must reflect the needs of the community it serves. Rural areas tend to be older in demographic make up, and healthcare provision is sparse. That cannot be treated as a marginal factor; it is the central planning reality. The rural premium in healthcare need is real, documented and consistently under weighted in funding decisions.

My party has always been a proud champion of rural areas. We recognise the postcode lottery of care provision and the health inequalities it perpetuates. It is why we have called for the establishment of the strategic small surgeries fund, specifically designed to prop up buckling services in remote parts of the country and ensure that where someone lives does not determine the quality of care they receive.

I thank my hon. Friend the Member for South Cotswolds (Dr Savage) for securing this debate. I will talk largely about Frome community hospital, but a lot of what she has said about test and learn and trial closures applies to Frome as well. I will also talk about the issues that occur when communities are served by organisations in different health authority boundaries and the impact of a lack of communications there.

Community hospitals, as we have heard, are the backbone of local healthcare. They keep people closer to home, ease pressure on our general hospitals and allow families to support loved ones through recovery without the burden of long journeys. That is especially so in more rural areas like my constituency, where travel times can be long and public transport is limited. For many of my constituents, Frome community hospital is an important community hub, where people access lifesaving care for themselves and their families. In fact, my husband’s life was saved by a team at Frome hospital earlier this year when he went into anaphylactic shock and was able to get to the urgent care department in Frome much quicker than he could have got to the general hospital in Bath. I put on record my thanks to the nurses who treated him that day.

Last summer, Somerset ICB cut the number of beds at Frome hospital as part of a test and learn consultation, the criteria for which seem very unclear to me. I know from visiting the Royal United hospital, our general hospital in Bath, that one of the biggest challenges facing it is getting patients discharged to appropriate community settings. My hon. Friend the Member for South Cotswolds talked about ambulances queueing; as I understand it, one of the main reasons that ambulances queue at our general hospital is because, at the other end of the hospital, patients cannot be discharged to community settings, yet we are cutting beds in those settings. I am therefore unconvinced that those cuts can be justified. I have continued to push for the restoration of the beds at Frome hospital, but I have also spoken to the ICB about the possibility of the hospital becoming one of the community hubs that the Government have rolled out, which I think could be a really good opportunity for semi rural areas.

Across the country, ICBs are taking very different approaches to consulting MPs on the roll out of these hubs. Some have engaged constructively and early, but in Somerset there was unfortunately no consultation with me at all. Instead, I was given a list of locations that had already been chosen, none of which were located in Frome and East Somerset. I do not believe that that is how engagement with elected representatives is supposed to work, which matters particularly for constituencies like mine.

Much of east Somerset sits across different local authority and health boundaries. Many of my constituents’ usual experience of hospital care is at a hospital that until recently was outside of our own ICB area altogether. When that hospital does not have proper joint working arrangements with our ICB, those patients find themselves effectively pushed to the back of the queue, simply because joined up planning between the two systems is not happening.

That is no fault of the patients or of the staff trying to care for them. It is a structural failure that leaves whole communities at a disadvantage because they happen to sit on the wrong side of a line on a map. However, in the Somer valley in my constituency, things are working rather differently. There, the relationship between Bath and North East Somerset council and the ICB appears to be working well, with genuine collaboration shaping local services. It shows what can be achieved when councils, communities and ICBs sit down together as equal partners from the outset.

I ask the Minister to ensure that the Department reinforces to ICBs, including Somerset, that consultation with local MPs and councils on community hub proposals is not optional but essential if communities are to be properly heard. My constituents deserve a community hospital that reflects the needs of a growing town and a process that treats them as genuine partners in shaping it. At a time when the Government are closing down Healthwatch, I welcome the Minister’s thoughts on how we can prioritise patients’ voices in health provision.

It is a pleasure to serve under your chairmanship, Sir Jeremy. I congratulate the hon. Member for South Cotswolds (Dr Savage) on securing this vital debate. I also commend the hon. Member for Cumbernauld and Kirkintilloch (Katrina Murray) for sharing her experiences in a community hospital setting, which were really interesting to hear.

When I think about community hospitals, I think about trust. I think about the residents in my constituency who lost Littlehampton hospital more than 20 years ago. They were told it would be rebuilt. They were told not to worry. Yet to this day, many local people, like my constituent Sandra, still talk about what was taken away from them. The site is still cordoned off, unused. When local NHS leaders ask my constituents to trust them today, they are speaking to people who have heard those reassurances before, only to see valued community hospitals taken away from them.

That brings me to Zachary Merton hospital in Rustington. For many of my constituents across Bognor Regis and Littlehampton and our villages, Zachary Merton is not simply a building: it is somewhere they received treatment, welcomed children into the world and visited loved ones receiving palliative care. It is somewhere that provided those services close to home when they were needed most.

The decision to permanently close in patient services and remove beds at this much loved community hospital has caused enormous concern. Residents packed a public meeting that I organised last month. Hundreds more have signed petitions, written to me and contacted my office. They are not asking for special treatment; they are asking for a voice. West Sussex county council’s health and adult social care scrutiny committee has already determined that closing Zachary Merton was a “significant variation” in service provision. That is vital because Parliament has established a statutory process for a reason. Residents trust those of us who sit in this place to ensure that those processes are followed.

We are not talking about moving a cupboard from one room to another; we are talking about the permanent loss of healthcare services. What on earth is the point of Parliament setting rules around consultation if local NHS leaders can simply decide that they do not apply? What is the point of local authority scrutiny committees examining those decisions if their conclusions can be brushed aside? What is the point of telling residents that they have a right to be heard if services can be removed from them before they are ever given that opportunity? That is what my constituents simply cannot understand. Frankly, neither can I.

I have formally asked the Secretary of State to call in the decision to close Zachary Merton hospital. I raised it again at Health questions only last week, and I will continue pressing until my constituents get the answers, consultation and respect they deserve. My constituents have heard this story before. They were told that Littlehampton hospital would close temporarily, but temporary became permanent, and 25 years later people still talk about the services that were lost. So when residents are told not to worry about Zachary Merton, can Ministers really be surprised that they are sceptical?

Community hospitals should be part of the future NHS, and they should help keep care close to home. They support rehabilitation and reduce pressure on acute hospitals. Most importantly, they give people confidence that local healthcare services will still be there when they need them. They must not become easier places from which to remove services. My constituents have already seen one community hospital disappear. Their trust must not be taken for granted again, either by local NHS decision makers or by this Government. They are determined not to see history repeat itself, and so am I.

I am grateful to all Back Bench contributors to the debate. We now move to the Front Bench speeches, beginning with the Liberal Democrat spokesperson.

It is a pleasure to serve under your chairship, Sir Jeremy. I thank my hon. Friend the Member for South Cotswolds (Dr Savage) for securing this important debate on community hospitals.

Community hospitals have been a core part of our healthcare system for more than 150 years. They are rooted in a strong tradition of providing care and a range of clinical services to support their local populations. There are over 500 community hospitals throughout the UK, and they vary considerably in the services they deliver as their fundamental focus is to adapt to ensure that they serve the needs of their local area.

Community hospitals serve as multidisciplinary sites for immediate care across both health and social care, bridging the gap between primary and secondary care services. This adaptation and integration of services in particular makes community hospitals so valuable in bringing vital health services into the community and truly serving the specific needs of the community they represent, whether they have a significant older population or are situated in an area of high deprivation.

The value of community hospitals cannot be overstated, as we have heard today. They are ideally placed to support effective prevention and the management of long term conditions. They have the ability to be flexible, change and adapt with their population. By reimagining what we can do with community hospitals, based around the needs of an ageing population and rising complexity, we can make a significant difference to patients.

I have seen the benefits of community hospitals at first hand in my constituency of Epsom and Ewell. Leatherhead community hospital, which is highly valued by the local community, demonstrates the importance of maintaining strong accessibility, continuity of care and patient flows across community health infrastructure. Leatherhead community hospital provides more than 33 specific consultation and out patient services, including a stoma clinic, physiotherapy rehab, and speech and language therapy, for the diverse population it serves. We must support community hospitals to ensure they can continue to provide such services.

Community hospitals also play a core role in reducing the pressures on larger acute hospitals. Their role will only continue to grow in importance as demand on NHS services continues to rise. Community hospitals support earlier discharge and step down care to patients who are medically fit to leave acute hospitals, but still need further support to regain their independence prior to being fully discharged.

The Health Foundation estimates that, in England, about 125,000 people enter intermediate care services each month. The cost of providing this care continues to rise, increasing the pressure on these underfunded services. The average local authority spend on a single episode of care in 2022-23 was 27% higher in real terms than in 2019-20.

Community hospitals provide intermediate care beds, so they free up hospital beds, reducing the high demand on A&E departments. That intermediate support is particularly important in rural and coastal areas where, as we have heard today, access to acute hospitals is often limited.

In 2021, the chief medical officer’s annual report on health in coastal communities provided official recognition of the range of healthcare needs across different rural communities. Those living furthest from healthcare services in rural and coastal areas are most at risk of experiencing inequalities, particularly when there are poor and unaffordable transport connections—not to mention the patients who, due to old age or disability, are unable to drive long distances to access essential healthcare.

It takes twice as long for people in rural areas to reach their nearest GP by public transport as it takes people in urban areas; it also takes about a third longer for those who drive, according to the Rural Services Network. Those findings were affirmed by Lord Darzi’s report on the NHS, which found that across much of rural England—including nearly the whole south west as well as much of the east of the country—there are fewer than 46 dentists per 100,000 people.

A Liberal Democrat freedom of information request found that waiting times for life threatening calls are 45% longer in rural areas than in urban areas. Community hospitals, like rural GPs, pharmacies and other healthcare services, have frequently been an afterthought. That situation is unacceptable: we must take action to change it, particularly given that the Government say they want to move services into the community. Access to vital community healthcare cannot be dictated by an unjust postcode lottery.

Community hospitals receive less funding and less attention than larger acute hospitals, resulting in workforce shortages and rundown estates. There has also been an escalating process of service reductions at many community hospitals. Often, these changes are introduced under the guise of being trials, but they almost always become permanent. Pragmatic changes to services because of shifting demand are sometimes necessary, but too often changes are made without proper consultation or a proper explanation to the communities affected.

The Liberal Democrats are clear that we wholeheartedly support the ambition to shift more care into the community, but we must get community hospitals to a place where they can complement and play a vital role alongside neighbourhood health centres. Rural communities know all too well the pressure that the healthcare system in their areas is under, and the important role that community hospitals play. Consequently, we have been calling for a rescue plan for rural health services, in which rural community hospitals would be an essential pillar.

As part of the plan, we have called for a strategic small surgeries fund to sustain services in rural and remote areas, as well as a strategy to close the gap in access to primary healthcare between urban and rural areas. We are also calling for an emergency fund to reverse closures of community ambulance stations and to cancel planned closures of services where they are needed, which would particularly benefit rural communities. We would put an end to the postcode lottery of care provision, which disproportionately impacts rural communities, through a national care agency. We need a new national drive for first responders in rural communities. We need to protect air ambulances, integrating them into the emergency care system, and to ensure that they receive adequate NHS funding in addition to charitable donations.

Will the Minister heed these calls and take the necessary steps to ensure that community hospitals that serve rural communities receive the support they deserve? The bottom line is that community hospitals are a service to us all. They are vital in the provision of care closer to home; they bring multidisciplinary services closer to the community; they bridge the gap between hospitals and GPs; they relieve strain on hospital beds and A&E departments; they support faster discharge and rehabilitation, and so help patients to regain their independence; and they improve healthcare access for elderly and vulnerable patients by reducing travel burdens for both themselves and their families.

I urge the Minister to reflect on the important calls that I, my hon. Friends and others across the House have made in this debate, to ensure that we are all doing all we can to better support community hospitals.

It is a pleasure to serve under your chairmanship, Sir Jeremy. I congratulate the hon. Member for South Cotswolds (Dr Savage) on securing the debate.

It is fantastic to have the chance to champion community hospitals and what they stand for and provide. I put on record my thanks to the Hinckley and Bosworth Community Hospital, which does fantastic work in my area, in Hinckley. Also, only last week, I was lucky enough to go to the one year anniversary celebration for my community diagnostics centre—a £24 million investment, set up by the last Government, that we have now carried through. To date, it has served more than 59,000 patients, and it is expanding the delivery of services that it can provide, meaning that services that are provided within the community and people do not have to travel to the likes of Nuneaton or into Leicester. That is exactly what the leftward shift is all about: bringing those services to the community.

It may come as no surprise that I have a personal connection to community hospitals—you might expect me to talk about my job, Sir Jeremy, but it actually began much before that. My father was a GP down in Dorset; on Christmas days, before we were allowed to open our presents, we used to visit the community hospital and do the ward round with all the patients. As a child I really looked forward to that—first, because I got to meet Father Christmas, but secondly, because of the family feel of that community hospital had. That is the essence of what these places provide: that ability to be within our communities, to give the support and the family feel that we want to keep hold of and treasure because it is so important. Especially when dealing with healthcare, we often forget about wellbeing, and that is what these community hubs can provide.

Looking at the Government’s direction of travel, it very much sets out how neighbourhood health centres should look, but it is not quite so clear about how that dovetails with community hospitals. How do integrated health hubs fit in with community hospitals? It is not clear in the 10-year plan, and it is certainly not clear in the documentation coming out. Given that the Government are expecting ICBs to commission those hubs, and given some of the stories that we have heard—for example from my hon. Friend the Member for Bognor Regis and Littlehampton (Alison Griffiths), who is championing and fighting for the services in her area—the worry is that the Government are not explicit on what ICBs should be doing on community hospitals. We have this intention and general belief, but the actual direction of how this will work is clouded.

I therefore pose a question to the Government: are they considering a national strategy for community hospitals—or even a definition? That is one of the biggest problems when we look up community hospitals. What is the definition of a community hospital? Are community diagnostic centres included in that, or not? What about intermediate care? What about step down care? What about clinics that provide endoscopy? I must admit that, when I look at community hospitals, I am never quite sure what the definition is; looking into the detail, I struggle to find any definition that the Government have come up with.

Those are key questions about the leftward shift. I think we all agree that that would be welcome, but it is about the delivery plan. Of course, the 10-year plan has no delivery chapter, which again leads us back to the questions for the Minister today. I appreciate that this is not her portfolio, but these questions will keep coming time and again: how do we actually deliver, and what does this look like in the guise of neighbourhood health centres?

On that point, when it comes to delivery, I would like to pose something to the Minister: it was reported in the news over the weekend that NHS capital spend could be under threat to fund the defence investment plan. I hope she will be able to stand at this Dispatch Box and say that that is categorically not true—but that is going to be important.

That leads me on to another question that I would like to pose to the Minister. The response to a written question about the abolition of NHS England and its impact on services stated: “The abolition of NHS England is causing no disruption to the development of new services.”

Will the Minister state that from the Dispatch Box? Certainly, from what we are hearing on the ground, the ICB changes—losing 50% through redundancies—are having a significant impact on the way in which services are planned and delivered. I am therefore keen to understand the rationale behind that statement.

To finish where I started, community hospitals really are the healthcare that feels human. They are local, they are close to home and they are something that we across this House should aspire to. That family approach is where we all want to be; it is how we get there that is the question for the Government.

It is a pleasure to serve under your chairmanship this morning, Sir Jeremy. I congratulate the hon. Member for South Cotswolds (Dr Savage) on securing this important debate. I thank all hon. Members who have taken part: we have heard from 10 Back Bench Members on the issue this morning. We have heard powerful accounts of the value of community hospitals and community health services more widely, and the difference that these services can make to patients and their families. That can be particularly true for rural communities, as we have heard.

I also want to acknowledge my hon. Friend the Member for Cumbernauld and Kirkintilloch (Katrina Murray). I think she said that she had worked for 22 years in community hospitals, and she spoke powerfully about being at work in her community hospital 10 years ago today when the news broke about our good friend Jo Cox. I join my hon. Friend in offering deepest condolences to Jo’s sister, my hon. Friend the Member for Spen Valley (Kim Leadbeater), to the wider family and to Brendan and their children. We can all recall where we were on that awful day when we heard the horrifying news.

This debate goes to the heart of a wider question: how we deliver more care closer to home, and the role of community hospitals in that future. That is why the Government’s ambition to shift more care out of hospitals and into communities matters so much. As we look to the future of the NHS, we want a stronger neighbourhood health service, better integration between health and social care and easier access to support, closer to where people live. To do this, we will deliver 250 neighbourhood health centres, with 120 of them opening by 2030. That will make it easier for people to access care closer to where they live, up and down the country. These centres will provide easier, more convenient access to a wide range of health and care services on people’s doorstep. We want to see a neighbourhood health centre in every community.

The Government have set out a great ambition, but the Minister is talking about neighbourhood health centres and we are talking about community hospitals. Where do they dovetail and how do they fit? What definition is she using to put this together?

Hopefully, I will answer those very points as I make progress in my speech.

We are already taking forward the neighbourhood health centres. The first wave of 27 neighbourhood health centres has been announced across England, backed by £50 million. Community health services are a vital part of our ambition on neighbourhood health and in moving care into communities. As we have heard, community health services deliver a wide range of services, from adult musculoskeletal services to community paediatric services and more.

Recognising the vital role that community health services play in neighbourhood health, and the wider health and care system, we have set clear ambitions through our medium term planning framework. For the first time, we have set a target for systems to reduce long waits for community health services. By 2028-29, at least 80% of activity delivered by community health services should take place within 18 weeks, bringing those services in line with targets for elective care.

In 2025, we published “Standardising Community Health Services”, which describes the core components of NHS ICB funded community health services for children, young people and adults. ICBs will need to adapt based on local needs and priorities. Further guidance was published in February 2026 with additional detail on the community health services that ICBs should commission. This is hugely important: we know that there is variation between the services available across the country and that there are long waits. That is why the Government are taking action to reduce unwarranted variation and cut those waits, so people can access high quality community services wherever they live.

I am sorry to hammer this home, but every single point that the Minister has made has been about community services. She is spot on, but the question is where community hospitals fit in. Are they the correct vehicle that the Government want to use to help deliver some of those services, or are the Government moving away from the community hospital model and into further hubs? Both would be reasonable approaches and could be defended or pulled apart. The question is what the Government are choosing, because it is not clear from the Minister’s answers which it is.

As the hon. Gentleman has acknowledged, this is not actually my brief. As much as I can try to answer his questions, I think I might have to commit that the relevant Minister will write to him on that specific point.

For patients who still require hospital care, we are delivering millions of additional appointments and reducing waiting lists across elective care. The Government’s elective reform plan sets out commitments to reduce disparities across elective care access and waiting times, including by improving practical support for patients through better transport options. Virtual care models will offer patients in remote areas better access and more convenience by providing services that are more responsive to their needs. Expanding digital access is also crucial to improving the experience and health outcomes for rural communities. Digital services can improve access for many patients, but they must complement, not replace, high quality, local face to face care.

I want to expand on that point because, as we have heard from Members, there are many elderly people in rural communities who may or may not have access to digital services. Will the Minister provide some assurances to me and my hon. Friends that elderly people will not be excluded because they cannot access services digitally?

Absolutely. Digital services will complement and not replace the face to face care, so we are developing the NHS app and expanding online consultations for those for whom it will be helpful. There will be digital triage and remote monitoring, allowing patients in rural areas to access more NHS services, but I take on board the hon. Lady’s point about ensuring that we do not exclude people.

It is important to recognise that decisions about individual services are made locally by NHS organisations, which are responsible for assessing the needs of their populations and planning services accordingly. As strategic commissioners, ICBs work closely with health and wellbeing boards, local authorities and other partners to identify the most impactful outcomes for their population. ICBs will choose the right delivery model for their local area to deliver these outcomes, enabling capable providers to lead local services designed to meet the needs of their patients. That means looking carefully at local need, rurality, the workforce, clinical evidence and the long term sustainability of services, rather than applying a one size fits all model. Those decisions must be accompanied by appropriate engagement with patients, staff and local communities.

The hon. Member for South Cotswolds highlighted an important challenge. Whether national ambitions are matched by what people say and experience on the ground is a question we must take seriously. If we are to successfully shift care closer to home, community based services must be equipped to meet growing demand. In Cirencester, as we have heard, local provision remains very important. Existing services continue at the hon. Member’s local hospital, including in patient and out patient care, therapies and the minor injury and illness unit. Local NHS partners are also testing how services can better meet local need, including a specialist 15-bed frailty complex care unit alongside a 28-bed intermediate care ward. These changes are being tested locally and evaluated carefully; I am told that no permanent decisions have been made.

I have made a careful note of the hon. Member’s five questions, as I am sure my officials have. I will ensure that the relevant Minister writes to her with further details on her specific questions; I will also request that they meet her, as her fifth request was about when that could be arranged. On staffing in particular, I can update her: the NHS workforce plan is to be published imminently.

The pressures that hon. Members have described are familiar across much of the country. We have an ageing population, an increasing prevalence of long term conditions, growing demand for rehabilitation and recovery services and, in some areas, significant population growth driven by new housing developments. These pressures make local community based services more important, not less. Meeting those challenges will require strong, joined up community services, with community nursing, therapies, rehabilitation, urgent community response, virtual wards, and primary care and social care working together across the needs of patients.

Ultimately, the future of community hospitals should not be considered in isolation. They form part of a broader community heath infrastructure that includes neighbourhood teams, community providers, primary care, mental health services, social care and the voluntary sector. The question is not simply how many community hospitals we have, but how we use our community assets and services to provide high quality care closer to home.

I am very grateful to the hon. Member for South Cotswolds for bringing this important issue before the House. The debate has highlighted both the enduring value of community hospitals and the important role that they can play in supporting local populations, especially rural ones. As we continue our work to strengthen neighbourhood health services and shift care closer to home, the experiences and concerns raised by hon. Members today will make an important contribution to that discussion. I thank all hon. Members for their participation in this debate.

I thank all Members who have contributed to this debate with wonderful and sometimes moving stories about the role that community hospitals have played in the lives of their constituents and who have shared their concerns. I also thank the Minister—I appreciate that this is not her brief—for stepping up today.

I echo the words of the hon. Member for Cumbernauld and Kirkintilloch (Katrina Murray) that community hospitals are “much more than buildings”. There is the expertise of the staff working there, and they are an important hub for healthcare in a community. While I welcome the announcement of 250 neighbourhood health centres, I would like the message to go back to the relevant Minister that we already have community hospitals that are well known and well loved in our constituencies, so I very much hope they will form an integral part of the NHS’s plans for the future. I thank the Minister for passing on my requests to the relevant Minister; I look forward to hearing more about them in due course.

I will end with a reminder to all of us that we are talking about human beings at a very vulnerable moment in their life. I was especially moved to hear about the urgency of the husband of my hon. Friend the Member for Frome and East Somerset (Anna Sabine) suffering anaphylactic shock. Local medicine delivery is not just sentimental or about harking back to a bygone era. It is so important to recovery that patients do not feel scared and do not feel far from home, their community, or their family, friends and neighbours, but feel that they are not so far from home and are still in the bosom of their community. Anything we can do to minimise their stress and maximise their sense of connection and comfort can only ever help the speed and quality of their recovery.

I thank all colleagues for their contributions today, and I thank you, Sir Jeremy.

Question put and agreed to. Resolved, That this House has considered community hospitals.

Sitting suspended.

I beg to move, That this House has considered funding for road maintenance in Nottinghamshire.

It is a pleasure to serve under your chairmanship, Sir Jeremy. The issue of the condition of roads across my constituency is raised with me more than almost any other. Since becoming an MP, I have been contacted by hundreds of residents about potholes, crumbling surfaces and roads that have been left to deteriorate for far too long. Time and again the message from my constituents is the same: our roads are simply not good enough.

In Mansfield, potholes are no longer just a nuisance; they are becoming local landmarks. Some residents tell me that they no longer bother trying to avoid them. They simply recognise them, almost like old friends on the school run or the commute. That may raise a smile, but behind that humour is a much more serious reality, because potholes are not just harmless inconveniences—they are hazards that damage vehicles. They also increase costs for families, sometimes by hundreds and even thousands of pounds. In some cases, they put human safety at risk—and not just of injury but sometimes death, and there are examples of that in my constituency.

I have also heard from constituents about significant damage to tyres, which leaves people stranded late at night. In an email typical of the many that I have received, one resident described being left alone in Mansfield in the early hours after a punctured tyre, waiting until 5 am for recovery and assistance, and feeling vulnerable and unsafe. Another constituent wrote to me about her local estate, where a single pothole on her street is almost impossible to avoid. It has caused serious vehicle damage. She explained that she no longer reports issues to Nottinghamshire county council, the highway authority, because she has no confidence that it will lead to meaningful change. Instead, she sees the same pattern repeated: small temporary patches of tarmac that break down again after a very short period, or potholes simply marked with spray paint and left for weeks.

The sense of resignation is perhaps the most frustrating part of all, and is something that I have heard many times. Roads are patched rather than properly repaired, problems are identified but not resolved, and residents feel that they are paying more and more in council tax only to receive less in return. Let us be clear that this is not just about inconvenience. Roads are essential infrastructure that people rely on to take their children to school, access healthcare and get to work. When they are in such a condition, there is a direct impact on daily life and our local economy. It is not acceptable that residents should be left facing repair bills, avoidable damage and safety risks because our roads have not been maintained properly.

How did we get into this situation? The basic issue is quite simple: roads do not last indefinitely without planned maintenance. They require resurfacing at regular intervals, yet that cycle has been allowed to slip far beyond what is sustainable. The Asphalt Industry Alliance reports that roads in England are now resurfaced on average every 39 years for principal roads, 60 years for B and C roads, and sometimes over 100 years for unclassified roads—far beyond the recommended 10 to 20 years. The gap is not just a technical detail; it is a structural failure. It means roads are being allowed to deteriorate until they break down completely, leading to expensive and reactive repairs. Once that happens, the cost spiral is immediate. Patching potholes becomes more expensive than prevention, and each intervention lasts less time. We are, therefore, spending more for worse outcomes.

Across the country, including in Nottinghamshire, that has created a repeating cycle of deterioration followed by temporary patching, further breakdown and repeat intervention: a managed decline that never resolves the underlying issues. Nationally, that has built up a substantial backlog, with independent estimates placing the cost of restoring local roads to proper condition at many billions of pounds, and large parts of the network close to the end of their structural life. In plain terms, we are dealing with not just potholes but the accumulated consequence of years of deferred maintenance and under investment—not the result of a single bad winter or short term disruption.

Under the Conservative Government from 2010, central Government funding for local authorities was significantly reduced, particularly during the Cameron and Osborne years of 2010 to 2015. We all saw the impact of that on our local councils across various services. Capital expenditure on local road maintenance in Nottinghamshire fell from £16.6 million in 2011 to just £12 million by the time Boris Johnson became Prime Minister in 2019.

Revenue expenditure on local highway maintenance, funded through council tax receipts and business rates, remained below 2010 levels in every subsequent year, and in some years reduced by more than 50%. In the final five years of Conservative Government, some additional and welcome funding was provided but, after taking inflation into account, the real terms cumulative loss in funding in Nottinghamshire alone over those 14 years amounted to tens of millions. Furthermore, because highways maintenance is not ringfenced, rising pressures from other areas forced local authorities to divert their limited resources to meet their obligations elsewhere, further weakening any capacity for preventive maintenance.

A double pressure emerged: increasing demand on council budgets and a road network requiring more investment just as preventive maintenance was squeezed. The result, after years of Conservative under investment, is a road network in Nottinghamshire that is increasingly worn out, more expensive to repair and reliant on temporary fixes instead of lasting solutions.

That responsibility does not stop at the national level. My residents and others across Nottinghamshire will remember when our county council was led by the Conservatives under my predecessor, Ben Bradley, who was simultaneously leader of Nottinghamshire county council and Conservative MP for Mansfield. As council leader, he failed to reverse the deterioration of local roads or secure the additional funding needed, despite being in a prime position to do so.

It is against that backdrop that the Labour Government have had to decide what happens next: whether we continue to manage decline or we finally move to a system where repair and maintenance of roads are done properly. Therefore, I am pleased that the Government have chosen the path of investment in our roads in Nottinghamshire, instead of the path of further deterioration and decline.

I welcome the fact that the Labour Government recently set out a record £7.3 billion national multi year settlement for local road maintenance across the country over the next four years. That is not just a headline figure; it is long term and guaranteed funding that gives councils such as mine in Nottinghamshire the ability to plan properly, move away from crisis management and invest in proper preventive maintenance. That is on top of the Government’s investment of £1.6 billion for this financial year, which is a £500 million increase compared with the last financial year. This is real year on year growth, rather than managed decline.

Under the previous system, funding for 2024-25 in Nottinghamshire stood at just £18.6 million. I repeat that figure for emphasis—£18.6 million. However, under this Labour Government, who have worked with the East Midlands combined county authority and Mayor Claire Ward, that figure has risen to £44.7 million in 2025-26, including £15.2 million of additional mayoral investment. It will rise again to £46.9 million in 2026-27, including £17.4 million from the mayor. That is tens of millions of pounds of additional funding in Nottinghamshire to help fix our roads. The contrast with what came before could not be clearer: investment under Labour, and decline under the Conservatives.

I therefore place on record my thanks to Mayor Claire Ward and the Minister for the leadership they have shown. Partnership between central Government and regional leadership is exactly how to fix long standing problems properly, because for years our councils were asked to do more for less. As mentioned earlier, preventive maintenance was completely squeezed, long term planning was undermined and, as a 2019 Transport Committee report made clear, the system was “fragmented”, “reactive” and failed to deliver the certainty needed to maintain roads properly. Recommendations that were made clearly at the time were not acted on by the previous Government.

Labour investment means that Nottinghamshire county council has both the resources and the responsibility to deliver, and what matters now to my constituents in Mansfield and to people across Nottinghamshire is delivery. I accept that there is a major backlog of repairs and that not every road will be fixed overnight. However, with these record funding settlements, Nottinghamshire county council cannot claim that it is not able to get this done due to a lack of funds. The money is coming in, I am glad to say; the question now is whether it can be used effectively at local level.

We are investing more than ever before, we are changing a system that has failed for too long, and we are giving councils the tools they need to succeed. However, I also make it clear that this funding must translate into visible improvements on the ground, because residents in Mansfield do not measure success in budget lines or policy papers. They measure it by whether they can drive to work without damaging their car, whether parents can safely take their children to school and whether their roads are finally fit for purpose. That is the standard that I believe the Labour Government are now setting, and I will continue to hold the council to account for making sure it is met.

It is a pleasure to serve under your chairmanship, Sir Jeremy.

I am grateful to my hon. Friend the Member for Mansfield (Steve Yemm) for securing this important debate. He spoke with real passion about the state of roads in Nottinghamshire, and rightly so, because this is not an abstract issue. It is about the roads that people rely on every day to get to work, to take their children to school, to support local businesses and, above all, to travel safely. For too long for people across Nottinghamshire, those everyday journeys have been made harder by roads that simply have not been good enough or safe enough.

My hon. Friend highlighted that this has not happened by accident. It is the product of years—indeed, over a decade—of under investment in our local road network: potholes left unrepaired, surfaces deteriorating, preventive maintenance deferred again and again. We are now dealing with the consequences of those decisions. This Government are determined to turn that around. That is why we are providing a record £7.3 billion for highway maintenance over the next four years, giving councils the long term certainty that they need to plan properly to resurface our roads and tackle the pothole plague once and for all.

Crucially, we are also backing the east midlands by providing £2 billion in transport for city regions funding through to 2031-32. Delivered through the East Midlands combined county authority under the leadership of Mayor Claire Ward, this substantial investment, devolved to the region, will enable transformational investment in local transport infrastructure, including roads, and empower local leaders to make decisions that reflect real local priorities, because we know that better decisions are made closer to the communities they serve. However, funding alone is not enough. It must be matched by delivery. That is why we have introduced a strengthened system of accountability, built on transparency, clear performance ratings and incentives for local highway authorities.

First, transparency. Councils now have to publish clear annual reports showing the condition of their roads, what they are doing to maintain them and how public money is being spent. That includes not just how many potholes they have fixed, but how they fixed them, whether repairs are built to last and whether they are investing in prevention, such as maintaining drainage and using surface treatments to stop potholes forming in the first place. My hon. Friend mentioned his constituent who had simply given up reporting a pothole on her street. It may be useful to point out that councils will now have to publish how residents can report road defects, how that information is used to prioritise repairs and whether people are kept informed once a problem has been raised. Transparency really matters. It gives residents a clear view of how their roads are managed, makes councils accountable for their choices and helps to ensure that funding is used to deliver long term improvements, not just short term fixes.

Secondly, ratings bring that information together into a clear, accessible judgment of performance so that residents can easily see how well their council is maintaining the roads they rely on. In the most recent assessment, Nottinghamshire was rated green for highways maintenance spend, but amber for the condition of its roads and adherence to best practice, resulting in an overall amber rating. That tells us two things: funding is reaching the right places because the council is spending the money allocated to it, but there is still work to do on improving road conditions and embedding best practice.

Thirdly, incentives. A share of the funding is now linked to clear performance requirements that every authority is expected to meet. That includes spending all the Government’s highways funding on maintenance rather than devoting it elsewhere. It also requires authorities to maintain up to date asset management plans, which ensure that maintenance decisions are based on evidence and long term outcomes rather than simply react to potholes once they appear.

Alongside that, we are supporting authorities to improve through highways innovation programmes such as Live Labs 2, targeted support for red rated authorities and updating the code of practice for well maintained highways. We are helping councils to adopt new approaches, build capacity and deliver better outcomes for residents. Earlier this year, we published the first national road safety strategy in over a decade, setting out how we will cut road deaths and serious injuries on Britain’s roads by 65% by 2035.

Let me be clear that this Government are stepping up. We are providing the funding, we are putting in place the performance framework, and we are backing regions such as the east midlands to succeed. On a national scale, we are already beginning to see the impact of that approach. In 2025, after nearly a decade long decline, the percentage of roads receiving maintenance treatment went up again, but it is for local highway authorities, in this case Nottinghamshire county council, to get on and deliver. That means more than just filling potholes when they appear; it means investing in long term preventive maintenance, making smarter use of materials and technology, and building a road network that is safer, smoother and more reliable for the future. Recent figures show that, while overall road fatalities have declined, far too many people are still killed or seriously injured on our roads each year. Every pothole that is left unrepaired and every surface that is allowed to deteriorate is a risk that we must take seriously.

I finish by returning to the central point made by my hon. Friend the Member for Mansfield: the people of Nottinghamshire deserve roads that are properly maintained. This Government are delivering the investment needed to make that happen, and we are putting in place clear expectations and accountability to ensure results. It is now for Nottinghamshire county council to turn that investment into results on the ground.

I thank my hon. Friend for securing this debate, and I look forward to continuing to work across the House, and with Mayor Claire Ward and local partners, to ensure that the people of Nottinghamshire see the improvements that they have every right to expect.

Question put and agreed to.

Sitting suspended.

[Sir Desmond Swayne in the Chair]

I beg to move, That this House has considered the impact of the University of the Air White Paper on lifelong learning opportunities.

It is a pleasure to serve under your chairmanship, Sir Desmond. I am grateful for the opportunity to lead this debate marking the 60th anniversary of the White Paper that led to the founding of the Open University, originally called the “University of the Air”. It is worth pausing on that phrase for a moment, because 60 years later it still sounds faintly otherworldly, even with all our electronic gizmos and gadgets and the information whizzing around us constantly. A “University of the Air” meant higher education broadcast directly into people’s homes. It meant learning being made available not just to those who had always had privilege, not just to the young or the affluent, and not only to those who followed a conventional academic route, but, crucially, to ordinary working people fitting study around jobs, families and the realities of their lives.

Sixty years on, what once sounded ambitious, perhaps even eccentric to some, instead now looks visionary. That is because it was visionary. It did not begin as some sort of administrative reform dreamt up in Whitehall; first and foremost, it was a political project. Harold Wilson first floated the idea in 1963, after seeing the potential of television and broadcasting to widen access to education in ways that had not previously seemed possible. But the person who really drove the project forward was his Minister, Jennie Lee.

There are not many White Papers that leave behind institutions that still change lives six decades later, but this one did, because Jennie Lee understood something important: there has always been a mismatch in this country—potential is spread far more widely and far more equally than opportunity. In the mid-60s, the assumption was still that higher education belonged to a relatively narrow section of society.

I congratulate the hon. Gentleman on securing the debate. On the narrow cohort of people who normally benefit from higher education, does he agree that lifelong learning is an essential component for young people from working class communities in particular? Many of them do not take part in traditional higher education, and they can and should be targeted so that we benefit not just now but for generations to come.

I agree entirely, and will make similar points later in my speech. The hon. Gentleman and I are very much on the same page.

Will the hon. Gentleman join me in recognising the Open University’s role in pioneering modules, credits and credit transfers, which turned lifelong learning into a reality for so many adults in my constituency? Does he agree that the funding changes in 2010 badly hit part time and mature learners, and that the promise of the White Paper still depends on the choices that Governments make on funding policies?

Funding is a huge issue here. The modular basis for the Open University has been a real boon to people who find themselves unable, for whatever reason, to study in a traditional format, but funding is still a key concern.

Back in the ’60s, university was for young people. It was thought to be for young people, usually at least middle class, studying full time and following a fairly prescribed path. The thinking went that if someone missed their opportunity at 18 or 21, that was that—they had had their chance. But Jennie Lee and the Wilson Government challenged that assumption. They believed that education ought not to be reserved for those lucky enough to travel a conventional route through life, and that people should have second chances—and third chances if they need them, and fourth chances too. Crucially, she insisted that there should be no lowering of standards and no second class offer for those who had missed out the first time round.

Perhaps the most radical thing of all was that the Open University would be genuinely open. The White Paper made it clear that people should be able to study irrespective of their previous educational qualifications. In other words, someone would not be shut out just because they had not done their A levels.

On all those points, the Government at the time were absolutely right, because the Open University has become one of the great success stories of modern Britain. Today, it is the largest university in the country, with around 125,000 students. Nearly a quarter of all part time higher education students in this country study at the OU. It reaches every constituency, including my own, Southport, where around 135 people are currently studying through it. This is not some sort of niche institution sitting at the margins of education policy but one of the central pillars of lifelong learning in this country.

I am grateful to my hon. Friend for celebrating such a great Labour achievement, led by a great Labour woman, Baroness Jennie Lee. Will he join me in congratulating the Open University and underlining its importance for people like me? I was looking after four children and was able to do a master’s at the Open University, spread out over three years, with some cutting edge modules that I still rely on now. The Open University opens up education for people from all backgrounds, offering home based and flexible learning, including for those with family responsibilities.

I am more than happy to commend Baroness Jennie Lee, and I am more than happy to celebrate the success of my hon. Friend and of the countless thousands of others who have studied around the real lives we all lead.

One reason why the Open University works is precisely because it understands something that many higher education institutions still struggle with: life is not linear. People do not all move neatly from school to university to career to retirement in a straight line. Our lives are messier than that. People leave school without confidence, drift into jobs and later discover different ambitions. They become parents, care for relatives, lose jobs, or their health changes. Sometimes, at 35, 45 or 55, they simply decide that they want to try something new. The original White Paper understood that. It explicitly talked about flexibility, recognising that some learners would move quickly and others slowly, depending on the realities of their lives. The Open University says something very simple to people in those circumstances: “It is not too late. It is never too late.”

I should declare an interest, because I would not be standing here in Westminster Hall this afternoon without the Open University. I did not come through the conventional route into higher education. I left school without much expectation that university was really for people like me. For most of my life, I worked in fairly ordinary, fairly low paid jobs. For instance, I sold “Magic Tree” air fresheners to petrol stations. I spent a decade working in a call centre for an insurance company. I spent a few soul destroying months working for a debt collector, before I could take no more and quit to go back on the dole.

Like many people, I found that without qualifications there were doors that simply remained shut, no matter how hard I tried. The Open University changed all that for me, although not in some dramatic overnight fashion like we might see in a television drama. It was hard work. It meant studying in the evenings, at weekends, on the bus to and from work—and, to be honest, probably sometimes during work if the boss was not looking. I was doing assignments when other members of the family were watching television or going out and getting on with their lives. But it made something possible for me that would otherwise not have been possible: it gave me the ability to learn around my life.

From speaking to other OU students over the years, I know that my story is far from unusual. There are hundreds of thousands of us out there who have rebuilt confidence, changed career, retrained or simply proved something to ourselves, because somebody, somewhere, 60 years ago had the foresight to build an institution flexible enough to meet people where they already are.

Something about all this is deeply embedded in the labour movement. The Open University sits in a much longer tradition of working class people organising to educate ourselves and improve our circumstances. Long before most people had access to university, we had mechanics’ institutes, miners’ libraries, mutual improvement societies, trade union reading rooms and university extension programmes. We had the Workers’ Educational Association. Working class people have always valued education, hard work and making something of ourselves. The nonsense about a lack of aspiration that we sometimes hear from the assembled ranks of the privileged has never been true. The problem was never aspiration; the problem was access.

In many ways, the “University of the Air” was the modern expression of that Victorian era working class tradition, and the belief that education should not stop, even when life gets complicated. That approach matters now more than ever. We live in a country where people are likely to work for longer. They change careers more often. They need to retrain repeatedly. We are also living through profound economic change, with automation, artificial intelligence, changing labour markets and an ageing population. We simply cannot operate on the assumption that education happens only once, in our late teens or early 20s, and then stops. Frankly, that never made sense, and it certainly does not make sense any more.

If we are serious about economic growth, improving productivity and helping people back into good work, lifelong learning has to move from being a worthy aspiration to being something much closer to the centre of how we think about our economy. Since being elected to Parliament, I have spent a lot of time working in the areas of employment, skills and economic inactivity, and I think we sometimes underestimate the role education plays in building people’s confidence as much as their competence. Often, people are not just missing qualifications; they are missing the confidence that they are capable of more. Adult education changes that. It changed it for me.

To be frank, I have forgotten quite a lot of the stuff that I was actually taught during my time at the Open University. I sometimes need a primer on the exact details of the theoretical framework underpinning the long run Phillips curve. When I re read my master’s thesis a few years ago, I surprised myself with how much I agreed with my conclusions on the intersection between liberty and unequal power relations. But I will never forget that moment back in December 2010, when I got my undergraduate result. It felt like validation. It was a confidence boost that has never left me.

In among the successes and the congratulations, we should be honest about the challenges—

My hon. Friend is speaking powerfully about his story and his experience of higher education. Young people from more advantaged or affluent backgrounds are still much more likely to enter higher education than their less advantaged peers. Socioeconomic background—what we more commonly call class—is still the strongest predictor of university attendance. Does my hon. Friend agree that the mission at the heart of the 1966 White Paper, to expand access to higher education and spread opportunity, is just as relevant today as it was then?

Definitely. If anything, it is even more important in 2026, with all the challenges we see around us.

As I said, we should be honest about the challenges. Despite the success of institutions like the Open University, adult participation in higher education has fallen over the last decade. Too often, the system still feels like it is designed around the traditional undergraduate who left school at 18, rather than the parents in their 30s or 40s, the worker retraining after redundancy or the person managing long term ill health while trying to rebuild their future. Yet mature students are not some small minority: more than a third of undergraduate entrants are mature learners. They are already a major part of our higher education system, whether we recognise it fully or not.

That is why I welcome the broad direction of travel on lifelong learning and the more flexible provision the Government are pursuing. The principle is right—people should be able to access education throughout their lives and in a way that fits around their work and family—but it remains true that implementation and delivery matter as well. If lifelong learning is genuinely to continue to work, people need a system they can understand and easily navigate. The funding regime needs to feel straightforward and fair. Flexible provision has to be properly supported. Employers need to be part of the conversation. And, frankly, we need many more people just to know that these opportunities exist, because too many adults still assume that higher education is simply not for people like them.

I ask the Minister to reflect on the role that institutions such as the Open University can play in regions like mine. One of its great strengths is that people do not have to leave their communities to access the opportunities available to them. That matters in places that have too often watched talent drain away, like the region I am from. Somebody in Southport or St Helens, in Birkenhead or Bootle, should not necessarily have to move away from their home town to improve their prospects. The Open University allows people to build skills while remaining rooted in the places that they love and that they want to contribute to. That strikes me as important, not just educationally but economically and socially.

I am proud that this Labour Government are acting in a way that is true to the founding vision of the Open University. The lifelong learning entitlement represents a major step forward. It is transforming the student finance system to support flexible, modular learning across people’s lives. For the first time, individuals will be able to access funding both for traditional degrees and for shorter courses, as well as retraining and skills development, when they need it throughout their careers. It is fitting that this reform builds directly on the principles pioneered by the Open University almost 60 years ago.

The OU’s expertise in modular, flexible provision will be vital in making the lifelong learning entitlement a success, but we must do more. We must ensure that part time provision is properly funded and properly supported, we must raise awareness so that more people know these opportunities exist, and we must ensure that lifelong learning is embedded across Government—yes, in education policy, but also in economic, employment and regional growth strategies as well.

As we mark 60 years since the White Paper, we should all do two things. First, we should celebrate one of the most genuinely radical and successful achievements of not just Harold Wilson’s Government but every Labour Government: an institution built on the belief that intelligence is not confined to one class, one place or one stage of life. Secondly, we should remember that the argument Jennie Lee made in 1966 is not yet finished. The central question remains exactly the same as it ever was: what do we do with potential that has not yet had its chance?

For millions of people, the Open University has represented confidence, dignity and a second opportunity. I know that, because in my case it changed the direction of my life. For that reason, if no other, I believe that the vision behind the “University of the Air” deserves not simply our admiration but our continued support.

It is a pleasure to serve under your chairmanship, Sir Desmond. I thank and congratulate the hon. Member for Southport (Patrick Hurley) on securing this debate. I should also declare that I am a graduate and alumnus of the Open University, so I recognise many of those of its attributes that he mentioned. Unfortunately, I did not take the same speedy course that he did; in fact, it took me eight years to obtain my Bachelor of Science (Open), doing a 30-point level 1 to a 60-point level 3, with the odd 10-point thrown in in between—former graduates will know exactly what I am talking about.

The hon. Member talked about the changes we have seen in the Open University. I started when everything was tutor marked assessments, which meant you had to post them to my tutor, and I finished when everything had to be submitted over the internet. There was always that panic when you pushed the send button at five minutes to midnight, hoping that your internet stayed connected until the tutor had received your full assignment. However, I do not go back to the times when members were setting video cassette recorders to record lectures on BBC Two at 2 am, as was necessary then.

The hon. Member talked about the Open University giving students the ability to learn while they were working. It also instilled deep seated personal management skills, because students had to meet deadlines, while maintaining a work life balance and family interaction. It is right that we recognise that on this 60th anniversary of the “University of the Air”. But we should also recognise the other things the Open University has done with regard to learning and education, including the “Green Planet” TV series, an environmental series co produced with the BBC and narrated at that stage by Sir David Attenborough.

In terms of the opportunities offered by the Open University, I think everybody in the Chamber will recognise that there are four Northern Ireland MPs here today—that is four out of 11 or, as one of my maths courses taught me, 0.3636 recurring, as the decimalisation of the representation here from Northern Ireland. The hon. Member for Southport talked about the value of the regions, and the Open University is greatly recognised and valued in Northern Ireland, because of its ability to deliver courses across the regions and across abilities as well.

In Scotland, we are very proud that Jennie Lee, the architect of the Open University, came from Lochgelly, which is in my constituency. The hon. Gentleman rightly touched on the importance of the devolved Administrations working with the Open University to create higher education opportunities for people who would not normally have them. In Scotland, 30% of students at the Open University have a disability support need. Does the hon. Gentleman agree that that is just one reason why it is important that the devolved Administrations, like the Westminster Government, work closely with the Open University to ensure that it can play its full role in lifelong learning?

I fully support the Member’s contribution. In fact, one in five Northern Ireland students is registered as having a disability. So the Open University opens up not just geographical and regional abilities but all abilities to lifelong learning.

Other Members have spoken about Jennie Lee, but I would like to diverge at this point and to take the opportunity to pay tribute to another individual, John D’Arcy, who was the director of the Open University in Ireland. John served 16 years in that post and just recently retired. I was working with him and through him, and his promotion of the Open University was testament to how we were able to produce it and forward it in Northern Ireland. It was very much his skill, his interaction and his time there that shaped the Open University as a public service. He did that with ambition and innovation and, above all, by always keeping people at the centre of it. We were grateful to John for all he brought to the university and that role.

One of John’s phrases was that the Open University in Northern Ireland was one of its best kept secrets, because the Open University was in fact the third university in Northern Ireland. It was during that time—I suppose from being a graduate of it—that I recognised that ability, and we were able, when I was Health Minister, to bring the Open University together with career progression and skill shortages and to marry the two up. At that point, we had 65 Open University undergraduate nursing places; currently, more than one third of Open University students in Northern Ireland are studying science, technology, engineering and maths subjects, and nearly 600 are training as nurses. One thing that was done was to allow people working as carers, but who did not have the opportunity to go to university to become nurses, to train in their workplace. What that did was bring a loyalty to many of the hospitals and wards, because people were being built up in the place they worked in and with the people they worked with. That was then able to be expanded into social work. The Open University was working with trusts and with our Department as well.

It is right and timely that we contribute to this debate, because now is the time to invest in high quality, flexible higher education. I also see a call there for the Northern Ireland Executive to introduce more flexible financial support for part time students and to progress a higher education funding review to reform the higher education funding model. In that way, they can properly support lifelong learning at a time when Northern Ireland needs to grow skills, improve productivity and widen opportunity, and we can realise the full potential of the Open University and those who have not had the opportunity, as the hon. Member for Southport indicated, to access third level education, which many employers are now looking for. It is with great pleasure that I support this motion.

It is always a pleasure to serve under your chairship, Sir Desmond. I say a big thank you to the hon. Member for Southport (Patrick Hurley) for highlighting the wonderful work done by those institutions that are slightly off the beaten educational path, so to speak. Although the higher education sector has changed dramatically in the past 60 years, the Open University has continued to evolve, change and adapt while remaining true to its founding mission. From its inception, it has moved with the times. What began with television broadcasts, radio programmes and handwritten papers has now become a model of digital innovation and interactive online learning.

It is always a real pleasure to see the Minister in his place. We look forward to his answers to the questions we will ask, and I will have some in my contribution. The Open University came to the fore, if we are looking back just to the last few years, during the pandemic lockdown, when it led the way. Remote teaching was suddenly introduced in schools and universities, but the OU had already been delivering distance learning effectively for decades; it was leading the way at that time. Although many institutions were forced to rush and to improvise a remote learning model, the Open University was drawing on years of experience to support its students.

The Open University has given countless opportunities to working class people who would otherwise never have had the chance to earn a degree. For many, the route to traditional universities had been out of reach, but the Open University offered a second, third or indeed fourth chance, producing graduates who have gone on to become nurses, teachers, engineers and community leaders, with many returning to the OU to complete their master’s degree and PhD. The hon. Member for South Antrim (Robin Swann) referred to the 65 who were on a course in his time as Health Minister and to the fact that it is now 600. That indicates just how many have been able to take advantage of this opportunity and to improve their life, improve their qualifications and improve life for others as a result.

The Open University’s commitment to inclusion was there from its inception. Long before diversity, equity and inclusion became a formal policy, the Open University had those values in place. Jennie Lee’s model has always welcomed students from every walk of life, judging them not on their past qualifications, age, sexual orientation, race or creed, but only encouraging them in their desire to learn—their motivation, their complete goal and purpose, and their desire to do more. It has been particularly transformative for women who put their ambitions on hold to raise families, meaning that they could return to education as mature students, often becoming the first in their family to graduate from university.

I can give one example. My hon. Friend the Member for East Londonderry (Mr Campbell) is away, but I know from his discussions with me that his daughter was one of those women. She wanted to have a family, so then returned to the Open University at a later stage to learn education. That mature student with a family took an Open University degree and is now head of her department. My hon. Friend’s daughter is one example that is replicated dozens or perhaps hundreds of times across Northern Ireland and thousands of times across the United Kingdom.

The Open University in Northern Ireland has delivered particularly impactful outreach in prisons and working class communities. Those things are sometimes lost, but they should not be. I will share two examples of initiatives: the Shankill women’s centre in Belfast and the Kilcooley women’s centre, in the constituency of the hon. Member for North Down (Alex Easton). They do excellent work, not just in North Down but in Strangford, in partnership with the Open University. I have worked with them over the years as they have helped women to achieve goals they never thought they could.

The Open University has brought higher education directly into communities that have historically felt excluded from it. If we can do that—if women and men can see the opportunities, as I have witnessed over the years—that is good news. The OU’s scope is remarkable. Graduates include men and women from their 20s to their 90s; Members of the Northern Ireland Assembly; and fellow Members of this House, including the hon. Member for South Antrim. A member of my office staff, who took an Open University degree, achieved her goal with those qualifications and advanced what she is able to do. That demonstrates the depth of its impact.

In our prisons, the Open University has delivered life changing opportunities. For many inmates, Open University courses have provided purpose and a pathway to a better future after release. At justice questions in the Chamber, we often ask, as I have done, to keep people away from the unsavoury parts of prison life and give them an opportunity to do something different when they leave. It is a wonderful opportunity for inmates to have the Open University in prisons across the land. I hope the Minister will confirm that what we have done in Northern Ireland can be done on the UK mainland as well. What is being done to encourage and enable those in prison to take courses and see a different future, one that they perhaps would never have seen if they had not been in prison? It is a golden opportunity to shape life and do better.

Today, a higher number of young people than ever are opting to enrol with the Open University after A levels but, because it is not currently included in the UCAS system, the OU is a less visible choice than traditional brick universities. I ask the Minister to consider including the Open University in the UCAS system to ensure that it is a legitimate and visible post A level choice for young people, alongside mainstream institutions. It should be, it must be, and perhaps the Minister will confirm that it will be.

The things that improve a society more than anything else are access to good healthcare, access to opportunities and a choice in education. The Open University continues to impact and change the lives of hundreds of thousands of students every year, who balance work, family life and life’s challenges with their studies. The OU offers no barriers to learning to anyone of any age. It is the very definition of lifelong learning, just as Jennie Lee envisaged many years ago. With the hon. Member for Southport and the hon. Member for South Antrim—and the party spokespersons and the Minister, whose speeches will follow mine—I celebrate the OU for its extraordinary and continuing contribution to people’s lives. It is lovely to see something that we Brits have done well.

Reflecting on the contributions so far, it is also worth noting that the Open University supports the members of our British armed forces through its courses.

I thank the hon. Member for reminding us that many in the armed forces have taken that opportunity. The opportunity is there within their busy lives, and the opportunity is clear. We must ensure that this proud and uniquely British success story keeps opening doors for generations to come. That has to be the ambition and the goal, and that is what we are doing.

It is a pleasure to serve under your chairmanship, Sir Desmond. I congratulate the hon. Member for Southport (Patrick Hurley) on securing the debate. I know that he is a passionate advocate and champion of the OU. I welcome the opportunity to speak on a subject that, frankly, deserves far more attention.

Opening access to education, rewarding hard work and helping everyone to fulfil their potential are aims that sit at the heart of the Liberal Democrat vision for a free and fair society. Our predecessors were wholeheartedly supportive of the spirit behind the 1966 White Paper and we continue to be so. It is right that we mark its 60th anniversary by celebrating the work that it set in motion.

In my constituency there are currently 240 Open University students: 210 undergraduates and 30 postgraduates. Nearly half of those undergraduates started their studies under the age of 30 and over a quarter declare a disability. That tells us something about how OU study fits around life. It is not a story that is unique to my patch. Nationally, 19% of OU students live in the most economically disadvantaged areas of the country, nearly 70% are already in work when they begin studying, and three in four arrive with no previous higher education qualification at all. That is a testament to the access mission that the OU embodies.

In preparing for this debate, I enjoyed revisiting the 1966 White Paper, its proposals and the debates that led up to it. Hindsight is, of course, a wonderful thing but after reading one Member dismiss the idea as an “inflated concept” in a 1965 debate, I could not help but reflect, 60 years later, that the OU has comprehensively answered that objection, becoming a much loved national institution.

It has also been interesting to reflect on the world of adult education at the time. The White Paper was explicit that the university would sit alongside a wider ecosystem of provision, not replace it. The Government of the day promised to make full use of “existing agencies, such as the Extra Mural Departments of Universities, the Workers’ Educational Association…and local education authorities.”

In fact, the White Paper returns to that point twice. The vision was plural: a national broadcasting university—at the time—working hand in hand with local night classes, adult education centres and further education colleges, each reinforcing the other.

The Open University itself has remained admirably faithful to that founding outward facing instinct. It partners with institutions that lack their own degree awarding powers, validating their programmes, and a high proportion of its graduates stay in their local area, contributing to the local economy. Five years after graduating, more than nine in 10 OU graduates still live in the postcode area where they studied, which I believe is precisely the kind of locally rooted impact hoped for by the authors of the White Paper.

What has perhaps not survived so well is the other half of the 1966 vision—the local ecosystem that the OU was meant to complement. Public funding for adult skills and community learning has fallen sharply since its peak in the early 2000s. Spending on classroom based adult education specifically has fallen by about two thirds over that period, and the number of publicly funded classroom based further education courses taken by adults in England has dropped from 5.4 million in 2004-05 to just 1.7 million last year, which is a fall of about 70%. Of course, that is not the OU’s doing, and further education colleges still do excellent work within a narrower remit, but the wider tapestry of provision that the White Paper authors assumed would sit alongside a “University of the Air” has thinned out considerably since.

Even the OU is feeling the strain of operating in that emptier landscape. Its own accounts for the last financial year show an accounting deficit of £27 million, which was brought back into a small underlying operating surplus only through a sustained programme of costs reduction, including the loss, sadly, of over 300 full time equivalent roles last year. That should be seen less as a reflection on the OU, and more as a reflection on a much deeper structural problem. The part time higher education market in England has been shrinking for years, and the OU, even as the strongest player in that market, cannot grow the pool of adult learners on its own. That is a job for Government policy, not for one institution’s marketing budget.

That is exactly why the choice of funding mechanism matters so much for mature and returning learners. The lifelong learning entitlement that the Government are bringing forward is a welcome step in the right direction, but the evidence consistently shows that loans are not a strong enough incentive on their own to get more people from that group into education or training. Financial anxiety is already one of the biggest barriers preventing people from returning to study. Older learners are understandably more risk averse than 18-year olds, and asking someone to take on the very debt they are trying to avoid to access more flexible and modular learning is not necessarily the answer.

Instead, we Liberal Democrats have long called for grants of between £5,000 and £10,000 to be made available to people at key stages throughout their life to support retraining and reskilling. To ensure that that funding is well spent, we would pair it with good guidance on the options available and make sure that it is usable across a wide range of institutions, from local further education colleges to national universities and, of course, the OU.

I hope the Minister, hearing praise from across the Chamber for the OU’s success in reaching learners of all ages, will give serious thought to that proposal for the long term, because it will matter more, not less, as time goes on. The world of work is changing fast, and maintaining a highly skilled, productive economy will require us to continually invest in our most precious resource—people.

Learning cannot be a cost to be minimised once an initial education ends. The OU’s own record bears out the difference that can be made: it is ranked third nationally for graduate employability, and it has innovative schemes such as the virtual internships programme, which was built specifically for distance learners who could never have accessed an internship through conventional routes. That is what lifelong learning looks like when it works, but it cannot fall to one institution. Perhaps the most important insight from the White Paper is that no single institution, however innovative, can deliver lifelong learning alone. That responsibility sits with Government, who have their own opportunity to address that.

Last October’s “Post-16 education and skills” White Paper restated the Government’s ambitions for the lifelong learning entitlement, which is due to come into force in January 2027. However, the secondary legislation and implementation detail that will determine whether it actually reaches risk averse adult learners, rather than just the 18-year olds who the loan model already works for, remain outstanding. I therefore hope that the Minister can set out not just the date for that detail but whether the detail will include any role, or ambition, for grants alongside loans. It would be fitting for the anniversary that we are celebrating today to be marked by such a step forward in adult education.

It is a pleasure to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Southport (Patrick Hurley) for securing this debate, and for sharing with us his personal journey to becoming an Open University graduate and the opportunities that higher education opened up for him. In his remarks, the passion of his political world view shone through, and though the very nature of my sitting on the Conservative Benches might mean we have some differences, I am a Lancashire man from working class stock, and I agree with him forcibly that education should be available to all and applied with hard work—that is the most powerful action for social mobility.

I pay tribute to my honourable Unionist friends from Ulster, the hon. Members for South Antrim (Robin Swann) and for Strangford (Jim Shannon), for their contributions. They eloquently made points about skills beyond education and the wider personal growth available to people who attend the Open University, and particularly how important the Open University is in Northern Ireland. The two examples of the women’s centres made it clear that the Open University’s accessibility has been transformational to some of those young ladies’ lives. The hon. Member for Strangford also made an interesting point about UCAS, which I was not aware of, and I look forward to hearing what the Minister says in response to that.

This year marks 60 years since Harold Wilson’s Government published the “University of the Air” White Paper, which, seeking to capitalise on the advances in television and radio programme learning, set out plans for an Open University to provide higher and further education for those unable to take advantage of courses in existing colleges and universities. Envisioned as a way to tackle pressure on university and college places following the post second world war baby boom by providing home study to university and higher technical standards, the plan for the “University of the Air” was to provide high quality education to more adults through television and radio lectures, correspondence courses, residential courses and tutorials, and study groups at community centres. Those ideas formed the basis of what we know today as the Open University.

Like the hon. Member for Southport, I pay tribute to the late Baroness Lee of Asheridge, Jennie Lee, who was instrumental in setting up the Open University, for all her work to promote lifelong learning. When it first opened to students in 1971, the Open University offered 25,000 places. Today, it has provided courses to more than 2.3 million people. It is clear that the Open University’s flexibility helps make adult education and lifelong learning a reality for thousands who might not otherwise be able to access traditional campus based study. Last academic year, 67% of Open University students worked full or part time during their studies. That speaks to a culture of ambition and opportunity that lifelong learning helps to cultivate.

More than just statistics, we can see the real impact of the Open University and lifelong learning in the individual stories of those whose lives it has transformed. I know how transformative lifelong learning can be from my own early childhood memories. My first memories were of my parents going to night school—in their instance, further education—on alternate evenings; my father got his electrical qualifications, and my mother got her accountancy qualifications. They set up a small business that was transformational for mine and my brother’s life. Many others accessing the Open University, whether they be working parents, people with caring responsibilities or simply adults looking to grasp the opportunities that, for whatever reason, were not available or accessible to them when they left school, have benefited from the empowerment that comes from being able to take their education and their future into their own hands.

I also want to recognise just how hard working and motivated many adult learners are, and the courage it must take to return to education later in life. As we heard during the debate, the ways in which learning can change lives, and the things that many people who have sought out training or upskilling go on to achieve, are truly extraordinary.

The previous Government were clear about the value of adult education. I am proud of the Conservatives’ record, which included introducing the apprenticeship levy, skills bootcamps and free courses for jobs. Together, those initiatives have helped to give adults opportunities to learn the skills that employers are looking for, which will lead them to better jobs, better wellbeing and better opportunities for the future.

The Conservatives also welcome the upcoming launch of the lifelong learning entitlement, which I understand will be available for courses from January 2027. Although the Minister may wish to take some credit for it, the LLE was put forward by the previous Government to give adults a loan entitlement of up to four years of post-18 education to use over their lifetime. Crucially, the previous Government envisaged the LLE for a whole range of adult education, including full courses at higher technical and degree level, and new modular funding. I am glad that the first of the new modular courses will be launching next year.

Raising awareness of the new overhaul of post-18 education funding will be crucial if we are to ensure that it can help unlock learning for as many adults as possible. I therefore ask the Minister how his Department is raising awareness of the new funding options that will soon be available for post-18 education. How does he plan to attract learners who might not have traditionally sought out lifelong learning and training opportunities?

The current Government say that they are committed to increasing funding for adult education. However, since entering office, they have instead cut the adult skills budget by 6%. Industry was rightly shocked, calling it a “shortsighted” move that will undermine economic growth, set back organisations and learners, and undermine trust in the Government’s vision for the country. Key sectors in our economy are calling for growth in adult education, not cutbacks.

I turn to lifelong learning in other forms, including apprenticeships. Although, as demonstrated today, we all know that a high quality university degree can set someone on the path to success and that higher education plays an important role in lifelong learning, it would be wrong not to acknowledge that it is not the case for every course. It is frankly a scandal that too many traditional university courses do not deliver jobs in the industry that they claim to serve. Some courses will draw people in with the promise of a stable and fulfilling career but deliver nothing but mounting debt and a dead end. That is why, if we really want to support lifelong learning, we must be honest about the real issue of funnelling young people and adults into courses that do not get them the jobs that they are seeking and do not allow them to repay their loans. It is also why we must ensure that quality apprenticeships are a real choice at age 18 and beyond, and a viable, equally esteemed alternative to university.

We have a serious skills shortage. Nearly half of vacancies in the construction sector and skilled trades are the result of skills shortages. As has been discussed, the Opposition are concerned by the Government’s decision to withdraw public funding for level 7 apprenticeships, cutting support for the highest level apprenticeships that provide vital routes for adult learners into skilled careers such as nursing. It is a major blow to social mobility for adult learners, shutting out talent from disadvantaged backgrounds and taking opportunities away from adult learners. Not only will culling level 7 apprenticeships hurt employers, but it is destabilising for university providers. It will hit institutions that have tried to open up opportunities for those who traditionally do not go to university, including, of course, the Open University. Since the announcement last year, what engagement has the Minister had with institutions, including the Open University, about the impact of axing level 7 apprenticeships?

For much of the last 30 years, our approach to higher education has hinged on the underlying assumption that successfully completing a traditional university degree is one of the best ways to boost a person’s opportunities in life. Young people and adults who pay tens of thousands of pounds to complete their degree, whether up front or through repayments, rightly and reasonably expect that it will boost their job prospects and income. If we really want to encourage lifelong learning, we must ensure that issues with low quality and dead end traditional degrees are addressed. A more flexible option may be part of the solution.

Lifelong learning should be for everyone. Whether that is someone taking on a new qualification to advance their career or pursuing a high quality university degree as an adult, the empowerment and opportunity that comes from learning is truly life changing. The Open University has played an important role in opening up opportunities for millions of adults. The Government must be prepared to address the serious issues that exist with both the current welfare system and low value university courses to ensure that those who invest in education at whatever stage in their life are rewarded with the opportunities they deserve.

It is a pleasure to serve under your chairmanship, Sir Desmond. I start by congratulating my hon. Friend the Member for Southport (Patrick Hurley) on securing this very timely debate and on the characteristically thoughtful case he made. I also give credit to the hon. Member for South Antrim (Robin Swann), a graduate of the Open University himself, who reminded us of the analogue age of VCRs and the magic of Sir David Attenborough.

I also thank the hon. Member for Strangford (Jim Shannon) for highlighting the genuine inclusivity of the Open University from its inception. He was also right to highlight the importance of prisoner education. Although it is not within my area of responsibility, I am very passionate about it, and I believe that the Open University and other providers have a really important role to play, given the captive nature of the audience and the chance for prison to be a place where people can genuinely turn their lives around.

I want to answer the question about UCAS before I turn to the wider debate. The Open University chooses to manage applications directly, partly because of the need for flexibility beyond the normal academic cycle, but information about OU courses, including modular courses, is available on the UCAS website.

I am keen not to get drawn too far away from the topic of the Open University, but I will respond in short to the shadow Minister, the hon. Member for Windsor (Jack Rankin), who raised issues regarding level 7 apprenticeships. This is an area simply of disagreement on policy and on where the resources that sit behind the apprenticeships levy—which is now the growth and skills levy—should rest. I am really keen, as is the Education Secretary, for those resources to be targeted very much at those who might not have taken the university path and for those entry level apprenticeship routes to be funded to the max. That is why that policy decision was made. I stand by it and believe it was the right decision on balance for the use of those resources.

My hon. Friend the Member for Southport speaks in this debate not just as an advocate for lifelong learning but as living proof of its potential. As he spoke about movingly, his example is of someone who enrolled with the OU at the age of 30, and five years later emerged with both an undergraduate degree and a master’s degree to their name. That, for me, is the Open University’s mission in a nutshell—not a makeshift second chance, but a genuinely world class route to opportunity for people who were not on academic pathways at the age of 18. That is why his advocacy carries such weight. In Southport, he has carried that conviction into the community at the heart of his constituency, championing the learning festival that took place in the town last year and being a strong advocate for improving educational opportunities more broadly. I have been lobbied many times about school buildings by him, so I can attest to that.

As my hon. Friend explained, it will be 60 years ago next February since another Labour Minister, Jennie Lee, published the White Paper, “A University of the Air”. She did so in the face of immense scepticism. Whitehall was snooty, the press was cynical and much of the establishment argued that the money should be spent elsewhere, but Jennie Lee was, in Harold Wilson’s words, “a tigress”. At a famous Cabinet meeting at Chequers just before the 1966 election, she argued that while the national health service was the greatest creation of the post war Labour Government, the “University of the Air” would make “just as much difference to the country.”

The White Paper made a radical argument that higher education should be open to all, regardless of background or prior qualifications, that learning should be flexible, rigorous and lifelong, and that new technology would carry academic excellence far beyond the walls of traditional institutions. Jennie Lee won that argument, and 60 years on, every part of that vision—open access, flexibility and technology in service of excellence—reads less like history and more like a description of the task that sits in front of us today.

The Open University, the institution founded as a consequence of that White Paper, is today the largest academic institution in the UK, with students in all 650 parliamentary constituencies. Since 1969, it has taught more than 2.5 million students worldwide. Three quarters of its undergraduates arrive with no previous higher education qualifications. The open door that Jennie Lee promised is still open.

In the last five years alone, more than 15,000 people who began studying without any A levels have earned higher education qualifications through the Open University. Two thirds of its students are working while they study. It is learning that fits around life—not the other way around. The OU was never second best: at the last assessment, 82% of its research impact was rated world leading or internationally excellent, and last year it was awarded gold—the highest ranking—in the teaching excellence framework.

We all, including the Minister, recognise that the Open University reaches out to those who are perhaps isolated and lonely. It gives them an opportunity to focus their attention on a degree, thereby giving them hope for the future. That is sometimes underestimated, but it is critical.

I completely agree. I will turn now to the Government’s actions, which will take the Open University to its next chapter, so that those opportunities are spread even more across our great country.

Last October, we published the “Post-16 education and skills” White Paper. There is a powerful alignment between the Open University’s mission to widen access and our own vision, set out in that White Paper, for a world leading skills system that breaks down barriers to opportunity. The strategy in the White Paper is the blueprint for delivering our new target for two thirds of young people to be participating in higher level learning—academic, technical or apprenticeships. We are determined to break the damaging link between background and success, and we want more people from all backgrounds to be able to access higher education as part of that.

As part of our reforms, the lifelong learning entitlement —a policy from the previous Government that I am very pleased we are continuing, with cross party support—represents one of the most significant student finance reforms in a generation. For the first time, it establishes a single, flexible funding system covering levels 4 to 6 across further and higher education, enabling people to learn, upskill and retrain throughout their working lives.

The rationale for the entitlement is clear. More than a third of vacancies go unfilled due to skills shortages, and around 80% of the 2030 workforce are already in employment. However, the current system was largely designed for younger, full time students and lacks the flexibility that adults in work need. The LLE will expand access to higher quality, flexible education and training, promote learner mobility and ensure that providers can respond to the needs of learners, employers and the wider economy.

Sixty years ago, a White Paper of just a few pages was dismissed as vague, insubstantial and impractical. Today, the institution it created has taught more than 2 million people, with my hon. Friend the Member for Southport among them. That is the test that Jennie Lee set us: not whether an idea is convenient, but whether it changes lives. She insisted that there could be no question of offering students a makeshift project, inferior in quality to other universities. Sixty years on, that standard still binds us.

From January next year funding will, for the first time, follow the learner, module by module, at any stage of life. Our ambition that two thirds of young people reach higher level learning is matched by an entitlement that lasts to 60, because opportunity should not have a closing date. Jennie Lee’s revolution was to say that the door to education should never close behind someone. The task of the next 60 years is to hold that door open wider still, in Southport and in every community like it. When our learners thrive, our country thrives.

Patrick Hurley, you have two minutes to wind up.

First, I pay tribute to you, Sir Desmond, for your exemplary chairmanship, Sir Desmond. I also thank Members from across the House for their valued contributions.

With your indulgence, Sir Desmond, I will touch on funding, a topic raised by several Members, through an anecdote about how I paid my Open University fees. When I studied at the OU, modules were around £700 each. Even that was too expensive for me. It was not until I realised that I could pay for my modules using Tesco Clubcard vouchers that I finally took the plunge and enrolled.

The choice was this: every few months, a booklet from Tesco would come through the post, and I would have the option of getting 50% off a Pizza Express bill, or free cinema tickets, or potentially transforming my life through higher education. Given the context, it was no choice at all—it was obvious what I should do.

Funding is never easy, but we need to redouble our efforts to ensure that the principle the OU was founded on—that education should be affordable and accessible to all—holds true not just for the last 60 years, but for the next 60 years.

Question put and agreed to. Resolved, That this House has considered the impact of the University of the Air White Paper on lifelong learning opportunities.

Sitting suspended.

I beg to move, That this House has considered Government support for West Midlands Police.

It is an honour to serve under your chairmanship, Sir Desmond. As elected representatives we hold various obligations to our constituents, but I suspect that few are of greater importance than giving residents the right to feel safe in the places they call home. For that reason, we must do all we can to support the brave men and women of our police forces.

This debate is more than about visible patrols that reassure parents taking their children to school, or swift responses to reports of crime. It is also about giving people the confidence that when something goes wrong, the police will deliver justice in a fair and proportionate way. In the west midlands, that basic promise has been undermined by years of budget cuts and neglect.

Across the communities of Birmingham Perry Barr, where knife crime, antisocial behaviour and gang violence are constant concerns, residents are not seeing enough police on their streets. The figures tell a grim story: compared with 2010, West Midlands police has 520 fewer officers on duty, on top of the 520 fewer police community support officers.

I commend the hon. Member for securing the debate. He is making a reputation for himself in the House when it comes to such subjects, and I wish him well. Does he agree that to have an effective police force, there must be community buy in? To have community buy in, people need to see the police on the streets each and every day, which obviously requires more finance. Does the hon. Member agree that the Minister needs to ensure that the Government make community funding the cornerstone of policing once again? Does he agree that community policing is the way forward?

The hon. Member is far more learned than I am in this House, and he makes a very important point. Community policing is of course the optimum type of policing, and I will deal with that point later in my speech.

To make matters worse, when we adjust for population growth, as we must, our area actually needs 640 additional officers compared with 2010. In real terms, then, we are not just 520 police officers and 520 police community support officers down; we are down by about 1,700 officers.

I thank the hon. Member for securing this vital debate. I represent the constituency next door to his, and I agree with much of what he has said. People are saying they need to feel safe on the streets. My constituency has had Operation Fearless, which has now expanded to the hon. Member’s area. It has been absolutely brilliant, because we have had extra police, but unfortunately it is only short term. Does the hon. Member agree that any future Government support for West Midlands police must guarantee targeted resources to support the work that is so desperately needed in local communities?

The hon. Lady is an amazing advocate for her constituency. She mentioned Operation Fearless, which produced amazing results in her constituency, and, as she rightly points out, I am fortunate that it is now being conducted in my Perry Barr constituency, where it has already had an amazing impact. But this should not be a postcode lottery; it should be spread across the whole region and across the country.

I want to give some figures, because it is very important for the Minister to understand the level of deprivation and decline. In real terms, the west midlands region is short of 1,700 officers: 1,200 police officers and 500 police and community support officers. I suppose one could ask for additional police and community support officers, because we have not adjusted that figure for population growth.

For far too long, the West Midlands police has been set up for failure by the Government’s funding allocation, which leaves the force around £43 million short every year. That shortfall risks a further loss of another 80 police officers, with the situation becoming so dire that the residents of Birmingham are being asked for an additional contribution through their council tax. They have already seen their council tax increase by 24% over the last three years, and now they are being invited to make good the shortfall by paying more, which simply is not acceptable.

What makes this failure all the more disappointing is that few areas are seeing their police presence eroded at the same scale as ours. While the vast majority of forces have as many personnel, if not more, West Midlands police continues to be left far behind. For years, successive Governments have known the challenge we face. They know that the system needs reforming, and to date they have done nothing about it. The Public Accounts Committee, the Home Affairs Committee, the National Police Chiefs’ Council, the Institute for Fiscal Studies, the chief inspector and even the previous Government all recognised that the formula is outdated and no longer fit for purpose, yet it remains in place.

The Government’s new police reform White Paper was an opportunity to address the injustice; instead, it has become another missed opportunity. Although we welcome the steps to fix local government funding, the White Paper puts police funding reform—the single biggest obstacle to tackling crime in our area—on the back burner, with reports that change will not start until 2034. Police funding needs to be fixed, and it needs to be fixed now.

Because many forms of crime, including violence against women and girls, are on the rise, the need for visible policing is becoming ever clearer. Since day one of being elected, I have been campaigning to put more police officers on our streets and make our communities safer. I am proud to say that after almost two years of hard work with West Midlands police, local organisations and residents, we have finally brought Operation Fearless to the Soho Road and Handsworth triangle area. That means more police officers on patrol, more arrests and a restored sense of safety for residents.

Operation Fearless is about more than just numbers. It matters because it puts officers where people can see them. It shows what can be achieved when the police work with communities, listen to local concerns and act on the priorities that residents themselves identify. Most of all, it works because people notice the difference. If we want to know how well we are tackling crime, we need to know whether people feel safe. I am afraid that if people have become so desensitised to seeing antisocial behaviour, fly tipping and any other crime that they no longer feel reporting achieves a result, that leaves them feeling vulnerable. That is not acceptable, and we must not let that happen.

Operation Fearless must not be the exception. It needs to be part of a wider approach across the constituency in places such as Aston, Lozells, Kingstanding and Perry Barr, and, in fact, across the west midlands. People should not have to campaign for more than a year to secure the basic police presence that every community deserves. But we can have that only when the people of the west midlands finally receive their fair share, and it is on the Government to deliver change.

At the same time, we must be clear that support for visible policing is not the same as support for prejudice in policing. The majority of my constituents have welcomed Operation Fearless, but that does not mean they accept draconian stop and search powers, racial profiling or predictive policing. I am glad to say that we have had discussions with our police officers about such issues, and they are very alert and receptive to our history, including the Handsworth riots. Our communities know what happens when policing is done to people rather than with them. Public safety depends on public trust, and if that trust is broken, everyone stands to lose. The Government must not only help the police to reduce crime, but tackle corruption in the force and prevent any miscarriage of justice.

Many of my constituents have expressed concerns about the case of the Birmingham Four. In 2017, Ali, Hussain, Rahman and Aziz were convicted of terrorism related charges after an operation conducted by the police. The police created a courier business and enticed the four men into working as drivers, using vans supplied by the police that were pre fitted with surveillance equipment. I understand that even though little evidence of criminal activity was found after months of surveillance, the four men were nevertheless convicted and sentenced to life in prison.

One concern raised by a member of one of the men’s families was that the entire case hinged on a bag containing incriminating items that was mysteriously found in Ali’s car on the first day he went to work, just an hour after he had given undercover officers access to the vehicle, and it is said that several more concerning revelations emerged during the trial. The undercover officers openly admitted to being accused of planting evidence in other cases, and later bragged about their “Oscar performance” while delivering evidence in court. Despite it being readily available, we understand that CCTV footage taken while an undercover officer was left alone with Ali’s car was withheld from the jury.

There was no conclusive DNA evidence, no proof that the men had bought the items in the bag, and no sighting of the men ever having had the bag, yet each of them was sentenced to between 15 and 20 years—

Order. The sitting is suspended for 45 minutes.

Sitting suspended for Divisions in the House.

On resuming—

Before the suspension, I was referring to the injustice felt in respect of the Birmingham Four. I did not do that lightly, but because of the demands of vigilance required. We all know about the Birmingham Six, who were wrongly convicted on the basis of police lies and spent 16 years in prison before being exonerated. The families of the victims and the wrongly accused are still demanding an inquiry into police failings and evidence suppression that occurred; to this day, that wait continues.

Of course we need more police on our streets, but we also need policing that is accountable, transparent and significantly worthy of public trust. The people of Birmingham Perry Barr are not asking for any special treatment; rather, they are asking for fairness and the police officers they were promised when Labour came to power. As I have said before, delivering on promises of safer streets, faster responses and support for victims must not become a postcode lottery. In practice, the message from my constituents is very simple: fix the funding formula, restore the officers we have lost, expand visible community policing, confront corruption, and rebuild the public trust on which all effective policing depends. The west midlands must not be treated as an afterthought. My constituents deserve so much more, and I urge the Government to deliver now.

Before I finish, I will just say this: we have an amazing West Midlands police and crime commissioner, who works with grassroots communities. I know that the Government have plans to get rid of police and crime commissioners, but I am certain that, in my area, the Mayor of the West Midlands cannot simply do two jobs. I encourage the Government to reflect on whether PCCs being left in post should be considered on a case by case basis.

It is a pleasure to serve under your chairmanship, Sir Desmond, and a pleasure to talk about policing, which is one of the most important aspects of any Government’s function—it is certainly the priority of this Government. When we came to power in 2024, we committed to reform policing because at the moment it is not fit for purpose. Our constituents feel, rightly, that they need a proper response to the epidemic of everyday crime in our communities. They know, and the police tell us, that we need to be better equipped to tackle the serious organised crime and sophisticated online crime increasing at regional, national and global levels.

The police, who are some of the most brilliant people in our country and do an incredible job, tell us that the technology they have is creaking at the seams. They cannot work as effectively as they want to because they do not have the necessary infrastructure or systems around them. Everything is complicated by layers of bureaucracy because databases are so out of date. I want to help our police officers and to be held accountable by our communities to improve policing. I am delighted that we have the support of most elements of policing for our police reform agenda, including the senior police to whom we speak every day. All the different organisations involved in policing agree that the structure is not right and we need to change it, so we are bringing in legislation soon to do that.

At the heart of everything we do is a commitment to improving the local policing offer. Above all else, we have to fulfil that commitment. We must establish local policing areas that are enabled to drive down crime, as the public rightly expect them to do. We will also have a regional structure that brings together some of the more sophisticated elements of our criminal investigations and has the manpower to do such investigations. At the top, we will have a national police service that brings together counter terrorism, serious organised crime and many other functions of policing, so that it can set the standard for what policing should be.

Alongside that, we will make policing more accountable —the hon. Member for Birmingham Perry Barr (Ayoub Khan) talked about accountability in policing—through a new structure for inspection and performance assessment, so that we have our eyes wide open to the challenges in each force area and we have the levers to improve performance where needed. He talked about his local police force. To reassure him on a few issues, he and I, and all hon. Members in this Chamber, would agree that we must ensure that our local police have the resources they need. This year, West Midlands police has £883 million in funding, which is a significant increase of £36.9 million on last year.

The hon. Gentleman quoted police numbers going back to 2010. I hope he appreciates that we cannot transform the numbers overnight, given the picture that he painted, and hope that he will be pleased that our priority is to make sure that we have more police in our neighbourhoods. Since last year there are, I think, 309 more full time officers in west midlands neighbourhoods than there were before. There has been a small overall increase in the number of police officers but a bigger increase in the number of officers who are in our communities, where we believe they should be.

Through the funding formula and direct money from Government, we are trying to incentivise more neighbourhood police. That is what our populations want, so that is where we are putting our resources. The 3,000 additional police officers and police and community support officers in our communities will begin to make a difference, but I am not for one minute suggesting that is enough. Our ambition is to have 13,000 extra police in our neighbourhoods by the end of this Parliament. I hope that the hon. Gentleman and other hon. Members will hold us to account on that ambition. Achieving it will be no easy feat, but we believe that it will transform how we do policing at local level because the police will be visible locally, able to gather intelligence about problems that are emerging, and able to tackle the epidemic of everyday crime.

Like other parts of the country, the west midlands has particular challenges, which we are responding to with the funding we provide. The serious violence programmes that we fund amount to £5 million for West Midlands police. The knife crime concentrations fund, which is the continuation of the funding that the hon. Gentleman mentioned, is a targeted fund aimed at tackling the very serious epidemic of knife crime that we know we must tackle in the communities where knife crime happens. There is a significant challenge in the west midlands, as there is in other parts of the country, and £2.8 million from the knife crime concentrations fund is going to the West Midlands police to enable targeted policing. There is also £5.4 million from the county lines programme, which enables us to join up across forces to understand the patterns of the lines that people are being coerced into running. On the one hand we do investigations to stop the criminals, and on the other hand we try to safeguard the kids being coerced into carrying drugs across county lines.

I know the hon. Gentleman will expect the Government to provide the support for the police that he rightly demands, but taken together, we have by some measure put extra money into funding the West Midlands police this year. Over and above that, we are using the resources we have to target the serious crime that we know is a problem in the west midlands, as in other parts of the country. I am focused on outcomes, rather than on the number of officers—although we are bringing a lot more officers into the neighbourhoods—and there are some quite good crime outcomes in the west midlands, not least the reduction in knife crime, which I hope the hon. Gentleman will join me in welcoming.

Question put and agreed to. Resolved, That this House has considered Government support for West Midlands Police.

Sitting suspended for a Division in the House.

I beg to move, That this House has considered access to dental services in West Sussex.

It is a pleasure to serve under your chairmanship, Sir Desmond, to have secured this debate—on Sussex Day, no less; I am confident that the Minister will have some excellent responses on behalf of all constituents in Sussex—and to have the opportunity to lay out the impact of the historic failings within the dental contract before the Minister.

The state of access to NHS dental services across the country is utterly disgraceful. In Sussex, 63% of adults had not seen a dentist in the two years prior to June 2025. Similarly, four in 10 children had not seen a dentist during that time. Fourteen million people were unable to access NHS dental care in early 2025 across the UK. The result of people locked out of NHS dental services has been a rise in cases of DIY dentistry, with a survey earlier this year suggesting that 7% of UK adults had attempted some form of DIY dentistry.

All that contributes to an alarming increase in hospital admissions for tooth related issues. Tooth decay is now the most common reason for hospital admission among children aged between six and 10, with more than 100,000 children admitted to hospital with rotting teeth between 2018 and 2024. Those figures outline a dire situation that is only getting worse. Improvements in oral health are being wiped out, and tooth decay rates are at levels not seen since the 1990s.

I commend the hon. Lady on bringing this forward. She is absolutely right that there is a dental crisis not just in West Sussex, but across the whole United Kingdom. Some 14 million people cannot get an NHS dentist. Whenever I look back—and I am old enough to look back, at my age—I think that perhaps we should move back to the situation I can well remember in the past, when there were full time NHS dental surgeries in community hospitals. They never let us down. Those positions must pay enough for dentists to be comfortable. Is that perhaps where we are going?

I thank the hon. Gentleman for his passionate advocacy for NHS dentistry in West Sussex. I am grateful to him for caring about access to NHS dentistry across the whole country. He is a fierce advocate for Strangford and makes the important point that the situation we are in is a damning indictment of the failure of the previous Government—a failure that the Prime Minister himself referred to regularly in the run up to the general election. It was a stick that he used to beat the Conservative Government with in every televised debate, when he spoke about rotting teeth falling out of children’s mouths.

We are still going backwards, dealing with problems on a scale not seen for generations, all at a time when the British Dental Association has warned that NHS dentistry is facing an existential threat. Parliament often hears the term “postcode lottery”, but I cannot think of a more applicable example than NHS dental services for residents in Chichester and West Sussex.

Last week I had the opportunity to conduct a little bit of research with a staff member who has recently moved to London and needs to register with an NHS dentist. Within two miles of his new postcode in London, 10 surgeries were accepting NHS patients. Entering the postcode of my constituency office in Chichester into the NHS search tool produced a very different result: zero surgeries accepting new adult NHS patients within a 12-mile radius. There were none within the city itself, and only one surgery was accepting new patients under the age of 17. That means that residents not registered locally have to travel to other towns and cities. At the time of looking, the closest surgery was in Littlehampton in the constituency of the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths). That is not close to the city of Chichester.

I ask the Minister what his solution would be for people attempting to register locally, people living in the area already and people moving to it after years of increased mandated development in my constituency. I would like to share with the Minister a few examples of what this means for my constituents in Chichester, who very kindly got in touch with me to share their stories. Kathryn moved with her family to the area four years ago. She still travels to Three Bridges for dental care. Christine still returns to the Isle of Wight for treatment. Marina and Denise moved to Bracklesham in 2011—15 years ago—and have never been able to register for an NHS dentist locally. Jim contacted me to say that he undertakes a 140-mile round trip just to receive routine dental care.

I commend my hon. Friend on an excellent speech. Some of my residents still travel to their NHS dentist clinic in Nottinghamshire, which is a more than 500-mile round trip from Cornwall. Does my hon. Friend agree that Cornwall integrated care board needs to sort out its underspend? This year, there was a £1.2 million underspend that could have been invested in vital NHS dental services. I understand that West Sussex is a good example: it has managed to reinvest any underspend money on the services that my hon. Friend is talking about, which are so desperately needed in West Sussex and in Cornwall.

My hon. Friend makes an excellent point about his local ICB. The underspend issue has plagued the dentistry contract over many years. The ICB for Sussex did manage to commission more urgent dental care using its underspend, meaning that it had very little to give back to the Treasury. That was absolutely the right thing to do; I commend my hon. Friend for recognising that that is an opportunity that Cornwall ICB could take. However, the Sussex ICB invested in urgent dental care while not addressing the problem that we have in routine dental care.

Residents in Chichester cannot access routine dental care in their own city and are forced to travel considerable distances. That takes time out of people’s lives, costs money, and creates additional risks. Imagine someone making that 140-mile round trip for a routine appointment, only to discover that they require an emergency procedure. They would be miles away from their home and family, and might not be capable of driving themselves home afterwards. That is completely unacceptable in today’s society.

To make matters worse, a number of individuals told me that they had been removed from their surgery’s patient list, particularly during the pandemic when they did not want to be in close contact with others. They had no notification that that was happening. Others were informed out of the blue that their surgery was switching to private care and that, unless they paid, they would need to seek treatment elsewhere. Given the costs involved, as reflected in the national figures, many simply choose to go without care altogether.

On top of that, individuals who have been lucky enough to secure an NHS place often face enormous waiting times for treatment. Jade shared her experience of being placed on a waiting list for routine root canal treatment and then being ignored for months. At 28-weeks pregnant, she suddenly found herself in excruciating pain and required emergency surgery. As we know, that costs the taxpayer a lot more than if the issue is addressed before it becomes an emergency. Another mother contacted me to say that three years ago her son developed an abscess over Christmas. They were unable to secure emergency treatment so they joined a waiting list at three separate practices. They still have not secured an appointment.

Those examples all point to a broken system in Chichester and across the country—one that is failing my constituents and worsening health outcomes. In the long run, it is also making the country poorer: the failure to invest in preventive care means that individuals require more serious and expensive treatment further down the line. This has to end. That view is shared by the dentists I spoke to ahead of today’s debate. A key issue raised by them and many across the profession is the state of the NHS dental contract. The British Dental Association identified it as a major factor driving NHS dentists into the private sector. The current settlement has been widely criticised since its inception back in 2006. The Health and Social Care Committee published a report in 2023 calling for an urgent overhaul of the system, and the Labour party promised to renegotiate the contract in its manifesto.

One former dental nurse who contacted me described the contracts as being like “tying dentists’ hands behind their backs.”

That is hardly practical if they are trying to perform a root canal procedure. The contracts are failing patients because the number of patients a dentist can see on the NHS is limited according to the units of dental activity that they have been commissioned to deliver. The nurse I spoke to suggested patients are being referred to hospitals for routine procedures because contractual arrangements prevent practices from carrying them out themselves and being renumerated.

The Government promised to reform the contracts, but they have been slow to address problems that are widely recognised across the sector. The consultation that the Government announced in April must lead to a contract that is genuinely patient focused, with greater flexibility in commissioning. When it was announced, the Government committed to bringing out the consultation before the summer, but the official line has changed slightly to “in due course”. I share the concern raised by campaigners that any further delay will mean that a new system will not be implemented before the end of this Parliament. Will the Minister commit to bringing out the consultation before the summer and to a firm deadline for when formal contract renegotiations will begin? Frankly, we cannot afford any further delays.

Another issue is costs. Lab costs went up 9% last year, but NHS contract holders got just a 3.55% uplift—add to that the hikes in national insurance contributions, which have exacerbated an already dismal situation. The British Dental Association believes that an average NHS dentist is losing £25 per routine dental check. Without support and changes to the contracts, many practices will continue to be pushed into the private sector, as we have already seen happen to many. In West Sussex, the number of dentists with NHS activity has dropped by 13% since 2019. I imagine that that figure is actually an underestimation, because a practice can offer just one NHS appointment a year and still feature on the list of NHS providers.

Local dentists are also concerned that the merger of the Surrey and Sussex ICBs, alongside a 50% reduction in ICB running costs, could undermine the local commissioning expertise and local relationships with providers. Can the Minister today provide any reassurance that, at a time of significant change within our ICBs, they will be given the resource to maintain and improve relationships with contract providers?

The Government talk a good game on dentistry, but they are tinkering around the edges and leaving major issues such as the contracts so far unresolved. They quietly dropped their manifesto pledge of delivering 700,000 more dental appointments, under the guise of broadening the definition of urgent dental appointments for clinical reasons. That is a sticking plaster that addresses the requirement for more urgent dental appointments, but does not address those who cannot get routine care, which in many cases would prevent them from needing the emergency care.

The Liberal Democrats have long called for reforms that will address the root of the crisis. Our £750 million plan would begin to undo years of underfunding, guarantee urgent and emergency dental care for everyone who needed it, and hopefully bring an end to DIY dentistry. That would be needed to address the backlogs in emergency care. I have heard of wait times of up to 18 months at St Richard’s in Chichester for complex dental treatment such as difficult extractions.

It is clear that the system is broken. Nobody is naive enough to believe that it can be addressed overnight, but the Government have had two years. All the while, residents in Chichester continue to have a lack of access to basic dental services. Dentists want to help patients, but it is not currently financially viable for many to stay in the NHS. That has to change, and I urge the Government to listen carefully to contributions from all Members in today’s debate, and take the steps that they promised in their manifesto.

It is a pleasure to serve under your chairmanship, Sir Desmond. I thank my hon. Friend the Member for Chichester (Jess Brown Fuller) for shining a light on this important subject, which causes such distress for residents of West Sussex.

The Department for Health, like many Government Departments, has promised a consultation, as well as extensive reform of the dental contract. I appreciate that the Minister wants to get this right. He has said that the dental system is complex. He has also made it clear in the past that these changes will not be rushed. Speaking to dentists across my constituency and beyond, very few people would say that taking two years just to start a consultation could be called rushing.

The Government need to be clear with both dentists and patients. Dentists were told that the consultation would come last year; then they were told that it would come before the start of summer—but summer is more or less upon us, and we are still waiting. At this rate, the Government risk making no meaningful reforms to dentistry within this Parliament. This sense of political inertia is, of course, not confined to one Department, and we do not have to look far to imagine the reason for that.

Alongside those delays sits an equally serious issue: funding. The Government have been clear that no new funding is available for dental reform; I imagine that the Minister himself finds that deeply frustrating. Only about 40% of adults are effectively provided for within the current NHS dental budget, and even that is propped up by an estimated £1 billion cross subsidy from private provision. The Public Accounts Committee was clear in its assessment: without frontloaded investment, meaningful reform has no chance of success.

What does this mean for residents in my constituency of Horsham? The honest answer is that we do not fully know, which is frustrating to say the least. Under the previous Conservative administration, West Sussex county council had not carried out a comprehensive oral health survey since before 2019. I have written to the new Lib Dem led council asking it to ensure that West Sussex is included in the next survey, because without reliable data, we simply cannot design effective or targeted reforms.

The data that we do have is deeply concerning. A quarter of children in West Sussex are at high risk of tooth decay compared with a national average of roughly half that level. From an early age, we are sending out the message that oral health is not a priority. At the same time, we are seeing a growing reliance on urgent dental care, but as a substitute for routine check ups. Preventive dentistry—the very foundation of a sustainable system—simply cannot function under those conditions. We risk raising a generation that engages with dental services only at a moment of crisis, and that will have profound long term health consequences.

I am very much seeing the impact of this in my Horsham casework. One of my constituents, Gail, was recently removed, along with her daughter, from the dental register. It was not from any fault of her own, but simply because there are not enough dentists left who are willing to operate on NHS contracts. That is distressing enough for patients, but it is also deeply frustrating for dental professionals, who find themselves forced to turn away patients who they can see are in urgent need.

Another constituent, Medi, does have access to a dentist, but not locally, and we have heard the same from other Members. She has to travel three hours for her appointments in another part of the country completely. She suffers from arthritis, so the journey is not just inconvenient, but very painful. However, she cannot find anyone closer, and even the waiting lists are vague about when a place may eventually be available.

I have also heard directly from dentists in Horsham. One practitioner, who has worked in the NHS for over 15 years and has trained NHS dental graduates, told me that, each year, funding has become more constrained and the administrative burden continues to grow. Without proper support for preventive care, he warned, dentists simply “don’t stand a chance”.

The hon. Member is making a powerful point for his constituents. Similarly, in Northern Ireland only 50% of adults are registered with NHS dentists. Almost 400,000 registrations have been lost since 2023, and ultimately practices are leaving NHS dentistry because it is financially unsustainable. Would he agree with me that there needs to be a UK wide look at this? While health is a devolved issue in Northern Ireland, there needs to be learning from the UK, because this is not just about waiting times, but about people finding a dentist who will actually take them on. Does he agree with me that we need a UK wide resolution?

I very much agree that this is a national crisis. Some local authorities or local ICBs are better than others, but this is basically a national problem and needs national action.

The dentist I mentioned has told me that many of his peers have already stopped offering NHS services, and the ones left are increasingly considering doing exactly the same. That tells us that the entire dental system is slipping into freefall. The broader figures reinforce the local picture. Only 40% of adults in West Sussex have seen a dentist in the past two years, which is a fall of 7%. Among children, the figure has dropped from 63% to 58%. Over the past five years, the number of residents per dentist in West Sussex has increased by a fifth. That is a huge jump, and further evidence that the system is heading for collapse.

From my conversations with the chief executive officer of the newly merged Surrey and Sussex ICB, I know that dentistry is a priority area for her and that the team are doing their best to introduce flexibility where possible. However, they face cuts of up 50% in budgets and staffing, which are enormous challenges not just for the leadership, but for the NHS teams on the ground. There is real concern that, unless we change now, dentistry risks becoming an expensive luxury, rather than a universally accessible service.

To conclude, the combination of delayed reforms and reduced funding is leaving patients without access to care and professionals without the support they need to provide it. Oral health inequalities continue to widen. I appreciate that this Government are once again picking up the pieces from their Conservative predecessors, but the obligation now falls on today’s Ministers. Unless we see a change in trajectory, we will be left with exactly what the Public Accounts Committee warned us about—no money, no reform, no teeth.

It is a pleasure to serve under your chairmanship, Sir Desmond. I congratulate the hon. Member for Chichester (Jess Brown Fuller), my constituency neighbour, on securing this very important debate. Access to NHS dentistry is one of the issues that my constituents raise with me most often, and when they do, they are not talking about contract reform, commissioning arrangements or NHS structures. They are talking about pain, cost, worry and ringing practice after practice but still not being able to get an appointment.

Anthony in Littlehampton contacted me after being told that he needed a crown. He is on personal independence payment and employment and support allowance. The treatment that he needs would cost hundreds of pounds. His question was simple: how is he meant to afford that? Clare in Bognor Regis did everything that patients are told to do. She remained with her NHS dentist and kept up with her appointments. Yet she was then told that NHS provision at her practice was being reduced and that she would be placed on a waiting list. Jill in Middleton on Sea is a pensioner who has spent years trying to navigate a system in which practices close, go private or stop taking NHS patients altogether. She is still trying to find care that she can afford.

Those are not isolated cases. They show what happens when NHS dentistry becomes too difficult to access. People wait, put treatment off and make compromises that they should not have to make, and then routine problems become urgent ones. We too often talk about dental care as though it sits separately from the rest of the NHS. It does not. Poor oral health affects confidence, nutrition, wellbeing and wider health outcomes, including in respect of heart disease and septicaemia.

One constituent who contacted me, Andrew from Bognor Regis, was undergoing treatment for two separate cancers. Through no fault of his own, regular dental appointments had—understandably—fallen by the wayside while he focused on fighting those illnesses. When he later tried to access NHS dental care again, he found himself in effect locked out of the system—abandoned at precisely the moment he needed support the most. What struck me was not simply his concern about finding dental care, but the wider impact that poor access can have on a patient’s healthcare journey. A patient battling cancer should not also be worrying about whether they can access a dentist.

However, there has been some local progress and I would like to recognise it. In Bognor Regis, mydentist is now delivering additional NHS dental activity and offering about 56 urgent appointments each week. That matters. Urgent appointments help people to get treatment when they need it the most, and stop problems becoming even more serious. The local ICB has also confirmed that new NHS dental contracts have been awarded for both Bognor Regis and Littlehampton, with services expected to open next year. That is welcome. But let us be honest: we are not where we need to be. My constituents should not have to become dental detectives simply to find treatment. They should not have to wait until pain becomes an emergency before the system responds. Urgent care is important, but must not become a substitute for routine access.

We also need to get much more serious about prevention. That starts with children. It starts in the early years with good habits, education and helping families to understand the importance of looking after their oral health. Prevention is better for patients, and it is also better for taxpayers.

Finally, we need to make every appointment count. I recently met Katie Cook, the practice manager at the new mydentist in Bognor Regis, and she told me that around 5% of appointments each week are lost because patients simply do not attend. This is not about blaming people—life happens—but a cancelled appointment can often be reused; a missed appointment cannot. When so many residents are desperate to be seen, that lost time matters. The national dental contract still needs reform, access needs to improve and patients need clearer routes to care when they cannot find an NHS dentist.

I will finish by asking the Minister three questions. First, what further steps will the Government take to improve access to routine NHS dentistry so that people are not forced to wait until a problem becomes an emergency before they can be seen? Secondly, what more can be done to support prevention, particularly among children and young people, so that we stop problems from developing in the first place? Thirdly, what assurances can the Minister give that areas such as West Sussex will receive the additional capacity needed to bring down waiting lists and improve access to NHS appointments?

My constituents do not expect miracles—they understand the pressures facing the NHS—but they do expect to be able to see a dentist when they need one. They expect a system that prevents problems rather than simply responding to crises, and they expect access to NHS dentistry to be determined by need, not by whether they can afford to go private. That is the standard my constituents deserve, and it is the standard they expect this Government to deliver.

It is a pleasure to serve under your chairmanship on Sussex Day, Sir Desmond. I start by congratulating my hon. Friend the Member for Chichester (Jess Brown Fuller) on securing this important debate on access to dentistry services in West Sussex. I also thank my fellow West Sussex MPs, my hon. Friend the Member for Horsham (John Milne) and the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths), for taking part in the debate. Of course, I particularly thank the hon. Members for Strangford (Jim Shannon) and for Upper Bann (Carla Lockhart), and my hon. Friend the Member for North Cornwall (Ben Maguire), for their interest in the debate and for making links between our experience in West Sussex and their experiences in their constituencies.

My constituents in Mid Sussex know all too well about the challenge of accessing dental services both for them and their children. An incredible 133,560 children covered by the NHS Sussex integrated care board did not see a dentist last year. That is 41% of them. The figure was even worse in 2024, with more than 140,000 children not seeing a dentist. Dozens of my constituents have contacted me to say that their local dentists are no longer taking NHS patients, leaving them and their children without the vital preventive dental care that they need and that we know saves the NHS a fortune down the line.

Recently, a constituent contacted me after spending months trying to find an NHS dentist. Practice after practice told her the same thing—that no NHS places were available. Faced with either a long wait or private fees she simply could not afford, she was left with nowhere to turn. Sadly, as we have heard during the debate, that story is anything but unique.

I apologise for intervening again, but I want to make a point about cancer patients, similar to the one made by the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths). The teeth of cancer patients are heavily impacted by the strength of the drugs, so does the hon. Lady agree that the Government need specifically to consider how they can support cancer patients post treatment and that cancer patients should be able to access free dental care quickly and efficiently?

The hon. Lady makes a really good point. We know that cancer treatment is a real priority for this Government and it certainly makes sense that her suggestion is considered.

I hear from parents who are worried about finding appointments for their children; I hear from pensioners who are living with pain while waiting for treatment; and I hear from families who are forced to choose between paying for private dental care and paying for other essentials. There is currently only one dental practice in Burgess Hill accepting under-17s and the same is true in Haywards Heath; they are the two main towns in my constituency. For too many people in Mid Sussex, access to an NHS dentist feels less like a right and more like a lottery.

When discussing this crisis, we often hear the phrase “DIY dentistry”. Its use has become so commonplace that we risk forgetting what it actually means. It means people pulling out their own teeth with pliers, or gluing crowns back into place. It means people attempting to treat serious dental problems themselves, because they cannot access professional care. A recent survey found that around 7% of UK adults had attempted some form of DIY dentistry. Over a third of those had tried to extract a painful tooth themselves; others had attempted to drain abscesses or repair fillings at home. People are doing these things because they are in pain and because they feel that they simply have no alternative.

The scale of the challenge to turn that situation around is enormous. As my hon. Friend the Member for Chichester noted, recent NHS figures show that around 60% of adults have not seen a dentist in the last two years, and over 5 million children did not see a dentist at all in the year to June 2025. Tooth decay remains the most common reason for hospital admission among children aged six to 10. That is truly shameful.

The previous Conservative Government left NHS dentistry in a deeply fragile state. Years of neglect and a fundamentally flawed dental contract drove dentists away from NHS provision, leaving patients to pay the price. Although the current Government inherited this crisis, they simply cannot inherit the excuses. The public were promised 700,000 additional urgent dental appointments, yet only around 100,000 have been delivered so far. Ministers might point to commissioning figures, but patients judge success by whether they can get an appointment when they need one. Far too many people across West Sussex still cannot do so.

I welcome any increase in dental places, and the Government have made moves in that respect. However, I am sure that we all accept that there will be a long pipeline before the trainees of today become the fully fledged dentists who are able to carry out work doing NHS contracts.

More importantly, training more dentists alone will not solve the problem. The dental contract remains broken, as we have already heard today. Dentists continue to tell us that the current system discourages them from doing NHS work and fails to reflect the complexity of the treatment that they provide. Unless the Government are prepared to commission and fund more NHS dentistry, increasing the number of dentists will not automatically increase access for patients. That is why contract change is so important.

In April, Ministers announced a consultation on changing the contract, with proposals expected before the summer. Midsummer’s day is next week. Patients waiting in pain cannot afford further delays, and dentists who are considering their future in the NHS cannot afford further uncertainty. The Government must set out a clear timetable for reform and ensure that implementation is not kicked into the long grass.

The Liberal Democrats believe that there is a better way forward. We have proposed a £750 million dental rescue package to end dental deserts and restore access to NHS dentistry. We would guarantee access to an NHS dentist for everyone requiring urgent or emergency care. We would fix the broken dental contract, expand training places, continue recognition of EU qualified dentists and put proper workforce planning into law. We would also guarantee free dental check ups for children, pregnant women, new mothers and those on low incomes while investing in prevention and oral public health, because if we are serious about solving this crisis, we must stop treating dentistry as an afterthought.

This debate is about real people in Mid Sussex and across West Sussex and the country. It is about the parent in Haywards Heath who cannot find an NHS dentist for their child, and the older resident in Burgess Hill who is living with pain while waiting for treatment. It is about families who are doing everything right, but finding that accessing basic NHS dental care is increasingly impossible. No one in Mid Sussex should ever be forced into DIY dentistry, and no child should end up in hospital because routine dental care was unavailable.

I would be grateful if the Minister could address three points. First, when will the Government publish and implement proposals for dental contract changes? Secondly, how will Ministers ensure that additional training places result in greater NHS capacity, rather than simply increasing the number of dentists working outside the NHS? Thirdly, what specific action is being taken to tackle unmet dental need and dental deserts in areas such as West Sussex? People in Mid Sussex and across our region deserve access to timely, affordable NHS dental care. I hope the Government will respond to this crisis with the urgency it demands.

It is a pleasure to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Chichester (Jess Brown Fuller) for securing this important debate, and for outlining the issues that her constituents—and, indeed, many constituents across the country—are facing. It is something of an irony that I find myself speaking on NHS dentistry for the second time in as many days, having co sponsored yesterday’s Backbench Business debate on precisely this issue, but if anything, that underlines the scale of the issue we are dealing with.

The hon. Member for Chichester will know that West Sussex borders my constituency, which spans Surrey and Hampshire. Many of my constituents in Haslemere and the surrounding villages routinely access services across that boundary, and would regard West Sussex as part of their natural health economy. I am sure the same is true vice versa, because dentistry does not respect administrative lines, and access to care either exists or it does not.

Let us be clear about the scale of the problem. Oral health is not a luxury issue; as my hon. Friend the Member for Bognor Regis and Littlehampton (Alison Griffiths) set out so clearly and passionately, it is fundamental to dignity, confidence, employability and overall health, yet access to NHS dentistry has become a postcode lottery. Nearly 14 million people are struggling to access care, and in many areas more than 70% of practices are not accepting new NHS patients, including children. As far as I can tell, not a single dentist in my constituency of Farnham and Bordon is accepting new NHS patients.

It is often suggested that we simply have a workforce shortage, but the issue is not that we do not have enough dentists; it is that, understandably, too few are willing to work within a contract that no longer makes sense. The 2006 NHS dental contract, introduced under the last Labour Government, is based on units of dental activity. It pays the same whether a dentist carries out one filling or six, rewards volume rather than complexity, and actively discourages preventive care. That contract is central to why the system is struggling.

The Government came into office promising a dental rescue plan, including urgent appointments, contract reform, workforce expansion and a greater focus on prevention. Those commitments were clear and repeated, yet delivery has not matched the rhetoric. In practice, the additional appointments that have been rolled out amount in many cases to only a small increase in urgent capacity. According to the British Dental Association, they are equivalent to a couple of extra slots per dentist per month. At the same time, the long promised NHS workforce plan has still not been published and, without it, there is no credible road map for how capacity will be met. Warm words about recruitment are no substitute for a clear and funded strategy that tells practices and patients what the future looks like.

We also need to recognise inefficiencies within the current system. In some practices, around one in seven NHS appointments is missed, costing individual surgeries tens of thousands of pounds a year. That is not just a frustration for clinicians—it is lost capacity in a system that is already under extreme pressure. However, rather than addressing the structural incentives that contribute to this, the Government’s response has been piecemeal. The consequences of all this are not evenly distributed; rural and coastal communities are particularly badly affected, with some having as few as 10 NHS dental practices per 100,000 people. These so called dental deserts are not accidental, but the predictable outcome of a system that does not align funding, workforce planning and local need.

There is a striking example of underused capacity in my local area. In Haslemere, the hospital contains a fully equipped dental suite that remains unused despite clear local demand. That facility could serve patients across the West Sussex border, given the natural geography of where people access care. Instead, it sits idle.

I think everyone in this Chamber agrees with prevention in principle, and with the need to move away from a purely treatment based model. The challenge is delivery. Likewise, workforce expansion is essential, but announcements without a credible plan do not translate into appointments. Ultimately, what is required is straightforward in principle, but urgent in practice: a properly funded and credible workforce plan, contract reform that rewards prevention and complexity rather than volume, and a serious strategy to address dental deserts that reflects real geography and need.

We should also acknowledge the previous efforts of the Conservative Government, including the dental recovery plan, which did attempt to address these issues through recruitment incentives, training expansion and support of overseas qualified dentists. I accept that some measures had limited uptake, but they were at least an attempt to respond to a growing crisis. The question now is whether this Government build on what works or continue to drift without clear direction. Patients do not care which Government designed which contract or which plan; they care about seeing a dentist when they need one.

I end with three straightforward questions that I asked the Minister in yesterday’s debate, but to which I did not get an answer. When will we see a fully funded and credible NHS dental workforce plan? How many additional dentists, hygienists and therapists are required to meet demand? What is the plan to ensure that dental deserts do not become a permanent feature of our healthcare system? Patients deserve these answers not in the future, but today.

It is a real pleasure to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Chichester (Jess Brown Fuller) for securing this important debate and I am delighted to wish her a happy Sussex Day. We may come from different political traditions, but she occupies Gillian Keegan’s former parliamentary seat, and I occupy Gillian’s former office in the Department of Health and Social Care, so we at least have that in common.

This is the second debate that I have responded to on dentistry in as many days—I was in the Chamber yesterday, and I am here in Westminster Hall today. That shows what a critical matter this is to our constituents, which is why this Government are taking clear action. On access to NHS dentistry, I point to 1.8 million extra treatments in the first seven months of the last financial year. In fact, taking the last full year into consideration, we are on track to deliver more than 2.5 million more dental treatments than in the year leading up to the general election.

As this is a debate on dentistry in West Sussex, I invite the Minister to share the numbers that relate specifically to West Sussex rather than to the country.

I am so delighted that the hon. Lady intervened, as I was about to come to that. We have reduced the underspend—one of the many utterly shocking things I found across my portfolio when we came into office in July 2024 was a £392 million underspend on NHS dentistry. We had an absurd situation where demand for NHS dentistry was going through the roof, but because of utter incompetence, the previous Government were underspending by £392 million. We were hands on on that. We have the ICBs commissioning; we have micromanaged this. I am delighted to say that we have got the underspend down to just £36 million in 2024-25. That is how we have managed to massively boost the number of treatments.

According to the most recent data available, the Sussex integrated care board, which serves the constituency of the hon. Member for Chichester, has delivered over 67,200 more NHS dental treatments. That is 11% more treatments between April and October last year compared with the same period before the general election. I hope that answered the question from the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths).

While we have made significant progress, I do not downplay for a second the issues faced by the constituents of the hon. Member for Chichester. Whenever I reel off these statistics in a debate or on the morning media round, I can hear people saying, “Okay, you say that, but where is my dentist appointment?” I understand that there are pockets of progress and areas where we are not at all where we need to be. But it is important to be realistic: 14 years of neglect cannot be put right overnight. The result of that neglect has been people doing DIY dentistry, and the No. 1 reason why children aged five to nine are going to hospital is tooth decay. It is a shocking and Dickensian state of affairs, frankly, and the Government take it very seriously.

As I said in the main Chamber yesterday, the solution is not to bring out sticking plasters and press releases, and to tinker around the edges. The sector needs long term reform, and the Government have laid the groundwork for a recovery that is based on solid foundations, not the sort of gimmicks that we saw under the previous Government. For example, the patient premium cost £126 million and we did not see any increase in new patients. We had to scrap that because it was a waste of time and money.

The most important thing we can do to end dental deserts is train the next generation of dentists in the relevant areas. We are taking steps to increase the supply of dentists across the country. Earlier this month, I announced the first sustained expansion of dental school places since 2007. Let that sink in for a minute. It is 20 years since we had any increase at all in dental school places, apart from a one off increase after covid. Backed by £11 million, a total of 50 dental school places per year have been allocated equally to the University of Portsmouth and the University of East Anglia.

In Bognor Regis and Littlehampton, and in significant parts of Chichester, we have coastal areas. In our manifesto, the Conservative party pledged golden handshakes to attract dentists to coastal constituencies, because we know that is one of the issues. Could you tell please me what specific proposals you have to attract dentists to coastal constituencies?

Order. I haven’t any proposals.

We will be publishing the data on the golden hellos in August, along with all the other data. There is a time lag from the end of the financial year to when we have collated all the data—it takes a few months—so there will be data in August on a number of issues we have discussed today. The challenge of golden hellos is that we run into problems around the contract, incentivising people to do NHS dentistry, and getting people to live and work in certain parts of the country when they might be more attracted to a big city. We are aware of the challenges for coastal areas.

On the Portsmouth announcement, I have never driven from Portsmouth to Chichester, but I understand it is about a 20-minute drive, depending on the traffic—

Will the Minister give way on that point?

Yes, but before the hon. Lady intervenes, I will say that I am fully aware that Portsmouth is in Hampshire, so I ask her not to give me a deluge of letters from her constituents.

I promise that I will not give the Minister a lesson in geography, although what he said suggests that he may not have frequented the A27. If somebody can get to a dentist in Portsmouth in 20 minutes, they are setting off at 3 am to do so, because that is the only time it can be done in about 20 minutes.

We clearly need to check our GPS on that one. I understand that there are challenges, but the point is that, for the first time in decades, Chichester has a school in its vicinity that is training dentists who will be within striking distance. Who knows where all the dentists will end up living when they have done the training? But our data suggests a strong correlation and causation between where somebody goes to dental school and where they end up putting down roots and working, living and settling. That is very much our hope for the 25 places that are, for the first time in 20 years, going to the University of Portsmouth, which I was pleased to visit just a few weeks ago.

I am sure the Minister will join me in congratulating Chichester college, which is creating a programme to train up the next generation of dental assistants and nurses. Staff there are excited to be able to contribute to addressing the recruitment issues in the Chichester area.

I strongly echo the hon. Lady’s congratulations to Chichester college. Of course, technicians, nurses and therapists play a crucial role; dentists’ practices function not just because of the dentist but because of the whole team.

It was, frankly, a travesty that the hon. Lady’s local area did not have a dental school, and it was a problem that Governments ignored for far too long. I am delighted that we have put that right, and hope she will recognise what a game changer it is. Whereas before, people had to train elsewhere and make an active decision to move to Chichester to practice dentistry, we hope that local people can now train up in the area and stay there if they wish to. That is a real incentive for people in Chichester to choose a career in dentistry, and to stay and serve in Sussex among the people they grew up with. It will also attract young people from across the country, who may choose to continue their careers, make their homes and put down roots in the area.

Similarly, the most important thing we can do for the long term dental health of the hon. Lady’s constituents is to make the shift from treatment to prevention. In 2024, more than one in 10 children aged five years old in Sussex ICB had experience of tooth decay, despite it being largely preventable. We are backing supervised toothbrushing through a national programme that will reach up to 600,000 children in the most deprived areas of England, backed by £21.5 million. Over £290,000 has been invested across West Sussex, East Sussex and Brighton and Hove, and over 45,000 free toothbrushes and toothpastes have been delivered through our innovative partnership with Colgate Palmolive. We are beefing up the soft drinks industry levy to remove more sugar from children’s diets and updating standards so that there is healthier food and drink in schools.

This year, we are undertaking vital reforms in dentistry. Two months ago, we embedded urgent dental care into NHS practices, making it easier for patients to get support where they need it most. The problem we heard time and again from the sector was that dentists were not incentivised to undertake NHS work, so we brought forward a package of reforms, from which I will highlight two measures. First, dentists are set to receive higher payments for treating patients who need urgent care, taking the payment for a unit of dental activity from approximately £42 to approximately £75. Dentists now have the extra incentive to provide urgent care for issues such as severe pain, infections or dental trauma on the NHS.

Secondly, from this month, those receiving complex care, such as treatments for severe gum disease or decay in multiple teeth, will be able to schedule a single planned package of treatment and pay one patient charge for it, rather than having several courses of treatment and paying a patient charge for each. That could save people more than £200 per year—money going straight back into the pockets of working people. We are also paying dentists more fairly for this work, to incentivise them. The appointments also mean that we are easing some of the pressures on St Richard’s hospital in the hon. Lady’s constituency, because we are preventing more painful conditions from spiralling into avoidable hospital admissions.

In a nutshell, our 2026 reforms are putting patients first and supporting those with the greatest need while backing our NHS dentists, making the contract more attractive and effective, and giving them the resources to deliver more.

The Government remain committed to rebuilding NHS dentistry after years of neglect. We have made a start with reforms to the dental contract that prioritise patients with the greatest need, support better access to urgent care and deliver a better deal for dentists. Alongside that, we are taking targeted steps to support areas where access is most challenging, including through workforce incentives, new school places and reforms to the exams process for overseas qualified dentists, which will deliver an additional 2,000 dentists per year by 2028. And we are just getting started: as I have said previously at the Dispatch Box, I remain firmly committed to delivering fundamental reform of the dental contract before the end of this Parliament.

However, meaningful reform requires careful consideration. The challenges facing NHS dentistry are complex, and there is no single universally agreed solution or perfect payment model. That is why it is important that we take the time necessary to develop reforms that are effective and sustainable, and that work for patients and the profession. I will continue to engage closely with dentists, representative bodies and patients to ensure that the reforms we bring forward address long standing concerns and support the long term future of NHS dentistry.

I thank all the Members who took part in the debate. This will not be something the Minister has not heard before, but I ask him to take this away: when constituents write to me saying that they are unable to register with an NHS dentist, if I send an email back to them saying, “But the Minister told me there were 67,000 more NHS dentist appointments in Sussex,” I am not getting an email back saying, “Bloody brilliant—I’ll forget it then. Don’t worry.” People are still frustrated and waiting. I am really glad that the Minister has committed to reforming the system, because it desperately needs it, and I look forward to holding his feet to the fire as he does so.

Question put and agreed to. Resolved, That this House has considered access to dental services in West Sussex.

Sitting adjourned.