COASTAL COMMUNITIES (HEALTH) BILL SECOND READING
Near-live transcript. Not the official record.
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5th of February. We now move to the next bill on the order paper.
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will now be read a second time. It's my privilege to be able to bring forward my Coastal Communities (Health) Bull before the House today, and may I start by thanking the Clerks of the Public Bull Office for thefor their support in bringing it to life, and for colleagues across our coastline for their expressions of support for it.
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live, sicker and die younger. Five years ago, the Chief Medical
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out the evidence and today this House has an opportunity to act upon it.
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pandemic, Professor Sir Chris Whitty sought to tackle another
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Major Challenge. He published a seminal report outlining health inequalities faced by coastal communities like mine in North Norfolk and across ourcountry. The findings are stark and shocking but clear. Across a range of measurable factors, those living in coastal communities were worse off
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coronary heart disease, lung conditions, obesity, substance abuse and addiction and mental ill health
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Their life expectancies were lower and the percentage of those lives lived in good health was lower too. We're an island nation. For an island nation to see poorer health outcomes
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exists the recommendations exist, what is missing is a system that turns them into action.
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and we live with them daily. What they did expose is how much coastal communities have in common in facing down these challenges and how much more we have in common with our coastal neighbours than many of our inland neighbours.Coastal communities could be a powerful force, and they need to be if the government is to deliver its ambitions for growth, green energy, strengthened industrial andnational defence and security. If our communities are sicker, then these aims will all be harder to achieve. For too long, the
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have not been part of the wider conversation about tackling health inequality. That's why I brought forward this bill today, Madam Deputy Speaker, because I'm determined to make suremy community in North Norfolk and communities anywhere on our nation's coast are being properly represented.
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First, let's look at the inarguable fact: Professor Whitty's findings continue to stack up with more recent research. An article published just weeks ago in the Journal of Public Health found that coastal communities in the south-east
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have life expectancy four years below their inland neighbours. In the east of England, it's three years lower. I've spoken before about how these can even be seen within counties, with notable differences
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Either end of the Acle Straight in Norfolk between Borland and Great Yarmouth despite them being only a few miles apart.
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Research from UCL published in the British Medical Journal over the summer also shocked me. Let me quote directly: "People who grew up and stayed in coastal areasbecoming more likely to
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land areas, and the people who move to coastal areas are sicker compared to
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he move away from them. I want the House to reflect on that for a moment. We have there evidence that suggests that for people in coastalThe best way to stay healthy could be to leave, and for those who aren't there currently, not to move there. This is an existential threat to coastal communities.
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as we know them.Action is not a choice anymore, it's a necessity. And this matters to the Minister for Health and Inequality, who's not in her place today, who's a respected champion and hard worker for theFind City of Hall In her area, people will live only 53 years of their life in good health. The average age of MPs elected to this place in 2024 was 48.So, whether the average MP, to become an average resident of Hall, they'd only have five years of good health left. I'm sure many of us have a great many things we still wish to do in our lives and which are reliant upon
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How would we react to being told we had five years before our health started to become noand impactfully poorer.
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That's not acceptable for the people who live anywhere in the country, and I implore the Minister today to support the Bull and make a change for all of our coastal constituents.
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together to deliver
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As I said during the health bill, the government's current aim to have a duty to tackle health inequality is commendable, but as drafted, it's flawed. There are no safeguards
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that coastal communities see the benefits of any of this work. Being at the end of the line, often disparately populated and with difficult challenges to tackle, it's possible the government willoverlooked them in favor of tackling health inequality in larger inland metropolitan areas.
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I beg to introduce a really important debate on health inequalities to this House.
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Ask somebody who is inland but has a large rural constituency.
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Mann issues he raised about health inequality are valid there in terms of
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the transport and the services. That's what they're coming. Don't you think that just by confining this tolocal community is somewhat stifling andmore important debate about health inequality more generally across the country.
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I thank him for the intervention. In fact, I would say to him that to tackle inequality truly, you need to work
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the same issues that I'm discussing today. If you start with the places the system finds hardest to reach, then you can design services thatup there and work inwards, because otherwise a national average can improve while the communities with the greatest barriers are leftexactly where they were. I will.I thank him for for taking this intervention, and does he agree with me that the men's health strategy is actually working from within and actuallyhaving diagnostic and GPs and mental health workers at farming auctions is a really great move forward that this government has put forward.
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a wonderful example of how designing from the outside in can work. We've seen it with buses,
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can effectively serve communities living in the remote outback. We can meet the needs of people living in rural and coastal
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the Bank of England
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I thank the hon. Member for giving way. In my constituency, it can take a very long time to get to the nearest hospital because a very smallnarrow lanes, especially in the summer when there
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heavy holiday traffic it can be almost impossible. And the ICB talked about
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not to do that. Would my hon. Friend agree that while merging some services is possibly going to beway forward to enable ICBs to cover
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choosing a service like emergency cardiac care where the distance is absolutely crucial and the time to hospital is crucial for survival, that that's perhapsthe wrong area to start when you're looking at service provision.It surely defies all sense, Madam Deputy Speaker, although I do of course understand, as she's alluded to, that for reasons of professional development and
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may not be possible to deliver all services in all areas, but acute and emergency surely is beyond reproach.
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And yet I'm yet to hear any understanding or potential safeguards for this risk from the Government either here or in the other place. There was no acknowledgement of it when I brought forward and spoke to an amendment on the health bill. or when Lord Patel did so in the other place, and I think the coastal communities deserve an explanation of why the government is not ensuring that they are
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I surely would on the condition that she allows me to join them because I'd really like to hear more about that work. I'm sure it would have a great impact on my part of Tees Valley, which is, Madam Deputy Speaker, quite abig part of the United Kingdom. I thank her for the intervention. Indeed, when I've tried to question the government on the specifics of their work, I've not received anything substantive. I askedJuly, how many meetings the Minister for Equalities has attended in relation to coastal health inequalities this year. I was told that ministers in the Departmentregularly on a range of topics including tackling health inequalities, to which coastal equalities is closely linked. I asked which meetings had taken place.I received a general assurance. I asked what specific work was being done and I was referred back to that general assurance. Ministersmust be able to tell Parliament what they're doing, who's responsible and what's changed. It's becoming a worrying
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that coastal health inequality is being kicked out to sea, and so I hope the Minister can provide us today with some straight answers on what the governmentis actually done and going to do to make a difference here. People in coastal communities want the reassurance that this House, which is more thanA hundred MPs representing coastal communities is placing legal duty on ministers responsible to tackle the issues that matter to them. lack of action or record of delivery is growing more and more worrying. The second, the other part of my bill relates to a cross-governmental coastal health strategy. Now, it's rare for politicians to admit when an
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New, it was a core recommendation
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of the Chris Whitty report in 2021. I'm sure the Government will be keen to point out that their existing health plans and strategies exist, and
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important work in places, they will not do enough to recognize the specific challenges of delivering coastal healthcare.
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For example, coastal communities suffer from the challenge of the 'half-compass effect' when seeking access to healthcare. It might sound obvious, but when residents in
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seek to access healthcare half of the directions on the compass that they could travel to take them straight
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in every direction.
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Just this morning, I received a letter from a constituent in Holt who said he was referred by his GP for an MRI scan but was told there was only availability at the Norfolk and Norwich Hospital, some 25 miles away.
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can't afford a taxi, there is no hospital transport available, and so he's declined the test. He asked me, rightly, how many other constituents find them selves in
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has to shape provision. If we take a one-size-fits-all approach to healthcare delivery,
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for Coastal Communities.
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It's only going to be half as effective.
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All the parts of the government that have an impact and interest in tackling coastal health inequality is important to bring together
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the action necessary to face up to this challenge. This speaks to the core of my vision for a country that works for people, to
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government around that life, Madam Deputy Speaker, give people responsibility for the outcome, the resources to deliver it,
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and the funding and authority to work meaningfully across departments, not just within annual budgets.
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Tackling coastal health inequality is a great opportunity to show this can work. Now, this bill doesn't list exhaustively all the things that the strategy shouldbut it does touch on many of the key issues which Professor Whitty identified and which I and my constituency and live with every day.
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The strategy would look at the recruitment and retention challenges of coastal communities, which come from being at the end of the line and lead to an extreme workloadfor those that do the healthcare work in our areas.
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The Chief Medical Officer's report outlined how there were 14.6% fewer postgraduate medical trainees, 15% fewer consultants, and 7.4%
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fewer nurses per patient in coastal communities. I've seen this firsthand in my area when it comes to pharmacy
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It was noticeable how many coastal towns in particular were impacted by that collapse. The localised factors of transport,
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would also be addressed in this strategy.
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When seeking to address health inequalities, the Government needs truly to understand how being coastal affects Croma and Sheringham in different ways to how it affects Whitby or Grimsby. TheCharacteristics of the coast—fishing, ports, tourism, rurality—all need their solutions to be well tailored.To that end, I would strongly encourage them to take a look at the excellent work of the Coastal Navigators Network, who have been taking on this great challenge and building a nationwide network of local government and health professionals to find solutions to
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opportunity. They understand how that investment, the time
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And the energy which is spent getting to the root causes of much of coastal inequality and deprivation can pay excellent dividends, both in well-being terms, but also in economic ones.
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wellbeing terms but also in economic ones. The test of this strategy will be what changes: how staff are recruited and retrained, how patients reach appointments and how investment prevents ill health. Each commitment needs an owner, a timetable and a measure of success. What we can't have is this becoming another nice document that becomes confined to a fate similar to that of Douglas Adams' display department in Hitchhiker's Guide to the Galaxy
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Similar to that of Douglas Adams displaydepartment in The Hitchhiker's Guide to the Galaxy where we might find the Coastal Communities (Health) Bull: Second Reading in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying 'BewarePublishing a strategy is not the same as delivering it. Ministers should return to this House and tell us what has
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What has failed and what they will change.Madam Deputy Speaker, when Chris Whittyon television screens every night, giving us evidence, making recommendations backed by data, and in the public interest, theGovernment listened to him and trusted him. We listened to him and trusted him. There has been no change in his methods in assessing the challenges of coastal communities. His reasoning and
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thought out as during the pandemic. Coastal health inequality is another challenge of our times, and
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Madam Deputy Speaker, the
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country begins for millions of people. It must not be where government's ambition ends.
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Give this Bull a Second Reading and make improving healthcare a responsibility ministers must answer for.
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The question is, the Bull be now read a Second time.I and colleagues know know what time this bill has to this debate has to end, so be mindful of the timekeeping, and I call Sadik Al-Hassan
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As many of this House know, before I was elected
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across the South WestBehind the pharmacy counter, I saw the health inequalities between coastal and inland communities.
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I worked as a community pharmacist for nearly 20 years.
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first hand
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The chief medical officer's report that's mentioned exemplifies this
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A long tail of preventable ill health. problem that will only get worse as populations age.That warning matters in North Somerset. Today, 11% of our
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That will rise to 14%.
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is over 75, but by 2043
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The 2021 census showed that people in coastal areas arewho likely to report bad or very bad health?
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Coastal Communities
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the hon. Member for
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of Norfolk mentioned
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Are harder to recruit in when it comes to health.
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first-hand experience myself of trying to recruit pharmacists, healthcare professionalspharmacy technicians and dispensers
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across coastal communities in the south west have shown me that it is problematicin those areas to
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the health professionals you need, and that's true of GP surgeries too. TheWest has the highest community pharmacy vacancy rate at 14%.
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and workforce planning needs to reflect the aging population in coastal communities too, which will
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I believe that there is a need for government to
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Transport and access to health hubs in coastal communities is more difficult.
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And that can be problematic not just for attending a GP appointment, getting to a pharmacist, but also that can be for a problem for getting to work.Forgetting to do that job in a healthcare establishment.
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Pharmacy tends to map towards the deprivation and health inequality
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in this country with higher amounts of pharmacieslocated where inequalities are greatest
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And that links to the Coastal Communities (Health) Bull: Second ReadingWhen pharmacy is impacted by funding cuts, when pharmacy is
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impacted by closures. That tends to hit those communities worse, like the closures of Jehú's pharmacies in Porth's Head.
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We lost two of the three pharmacies in that area, meaning there was only one
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So, thankfully, thanks to the help of MagniPharmacies, we've managed to reopen those two pharmacies, but health
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communities are particularly vulnerable when it comes to closures.
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I'd be happy to give way.
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a duty to have regard to address reduce inequalities between people in England in respect to their access to health services.
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Would he agree with me that ministers should be particularly mindful of the
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I'd like to thank my hon.
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disability for coastal communities because I believe the health
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urge the government to take them forward.
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in public health research, and that gap leads to worse inequalities. aging population adds to pressures on local services from getting appointments at GP
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that your postcode should never dictate your health outcomes.
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And I will continue to champion the health of North Somerset's coastal communities. Today,
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English Bull on behalf of coastal communities around the country.
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Hundreds of families in North Devon constituency I have now spent three months
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without an operational
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Shame. And more than over 200 births have been right
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NHS Exeter. Mann of my constituents feel that if this crisis had struck in Exeter or Bicester
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It is not acceptable that an expectant mother in coastal
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cause many families to feel that the worst could happen while travellingespecially in our areas when we've got a heavy volume of tourists and
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to which is a national
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great that we haven't seen the maternity unit reopen there. Does he agree with me that in areas like both of our constituencies, poor
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Locking out our constituents
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has a direct bus
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sing healthcare
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North Cornwall, not a single
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to a major
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is an no from the hon. Gentlemen's
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to help me on this campaign to get the maternity unit reopened.Many of these coastal towns have only very basic healthcare provision locally, and that is reflected in people's quality of life and life chances.Coastal healthcare is a crisis that overlaps with poor housing, few economic opportunities, limited transport, as we've just heard, and other disadvantages.
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In one part of Africa, Madam Deputy Speaker, life expectancy is a full 10 years less than otherparts of Devon. This bill rightly says that the Secretary of State should be made to come to this chamber and account for those disparities.
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Coastal towns have so much to offer, but across the country there is a pattern of too many coastal townsand an up in the category of have nots. A national strategy should exist to counter that and deliver good old
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for every coastal community. First Reading. in my constituency have been left all at sea.
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And the government must take this bill seriously. Thank you.
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Amanda Martin.
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Our coastal communities are special places, but we know that many face challenges that can have a profound impact on people's health, well-being and indeed life expectancy. Deprivationlow wages, poor housing, poor air quality and educational opportunities and an isolation play all play a part.One area where these inequalities are particularly concerning and one I want to concentrate on today is mental health. Research shows that young people in England's coastal towns are
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many faced challenges that can have profound Give me. After Amanda Martin I will be calling Steve Darling. Amanda Martin.
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more likely to experience a mental health condition. Behind that statistic are young people and families desperate for support, and people whose conditions worsen because simply help isn't availablewhen they need it. These challenges are very real in my own constituency, Portsmouth, a coastal city. We know that too many people in our city are struggling with their mental health. An estimated 15.4% of adults have been diagnosed with depression, above the regional and the national average.
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Behind these figures are people trying to cope, families worried about loved ones, and individuals who are not able to get the help they need. And getting thisis also not easy because Portsmouth has 2,133 patients for every GP. That's compared with 1,634 nationally.So this puts an enormous pressure on primary care and makes it hard for people to access support early when it can make the greatest
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And the picture, Madam Deputy Speaker, for children's mental health is equally concerning. Hampshire and the Isle of WightSpends just
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£66 per child with an actor referral to mental health. That's the 10th lowest in England, and by comparison, Northand spent 2,410. And even more troubling, 40% of referrals are closed before a second contact. The heard highest ratein the country. These are not figures; they represent children and young people who need someone to listen, families looking for reassurance and peopledeserve consistent support rather than being left to navigate the system alone. I therefore welcome the Government's commitment to opening 159 new NHS mental health facilities across England, bringingsupport close to home and intervening early because it can make a real difference. But too often, when community support is unavailable, people experiencing a mental health crisis end up in our A and E.
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Our A&E staff do extraordinary work, but A&E cannot replace the specialist ongoing care that people need. We must give peopleto the right support in the right place at the right time.
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That is why I'm disappointed that Portslade has not selected for one of these new facilities, given the level of need in my city, and I believe Portslade should have been considered, so I welcome the opportunity to work with the Minister to see how we can make this happen.All of these figures, Madam Deputy Speaker, are real people and real families, and I Itoo many young people, particularly, have lost their lives to suicide in Portsmouth. And I want to just pay tribute to Tegan Hyde and everyone involved incampaign. I want to thank them for meeting me and sharing their friend's story. Their determination to honour Glade's legacy and improve mental health support in RCD deserves recognition. Glade Clarke was a 23-year-old
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Who sadly died of suicide on thethe 6th of August 19 2026
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If we are serious about tackling health inequalities, we must recognise that coastal communities have distinct needs and ensure they are not left behind. People in my city of Portsmouth have deserved the right to the samedeserves the timely, high-quality mental healthcare as everyone else in the country, and I hope this government will continue to work with local communities like mine to make that a reality.
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Madam Deputy Speaker, and Torbay is often known as the English Riviera, and
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to offer. However, behind the beach huts and the palm trees, we have high levels of deprivation.
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as a Liberal Democrat MP. And I'd also like to pay tribute to Lincoln Sergeant, who's our Director of Public Health. He is nowand he was at the time of the Crispin Blunt report and wrote a chapter on Torbay and I was leader of the
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it has the highest level of deprivation for any constituency that
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communities across Torbay, whether it's in respect of
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alcohol or
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Kate Lissette, who's the chief medical officer at Torbay Hospital, and she shares with me how many peoplepatients who come into Torbay Hospital share that they see living to your 60s as a good age.
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depression, and I was only speaking this morning to a lady who attempted
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is absolutely shocking. And some of the challenges that we face is high levels of morbidity due to respiratory
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fabric that makes up this challenge is us having only 8% social rented
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we have the third lowest income
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Thank you, Madam Deputy Speaker, and I thank my right hon. Friend for her point of order there.
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The then Prime Minister,
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dressed in high-vis jackets, which definitely made them look like ordinary members of
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August listening tour in Ilkeston
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One of my fantastic former
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Several of the party leaders have done so over thethe intervening years.
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Has Earawashi's status as a perennial key marginal done it any great
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Sure, Leong Eaton was the first was in the first round of levelling up funding under the previous government, but it
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but parts of it, and especially Ilkeston, can really be considered as such.
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one of the smaller parts of my constituency. I am making at Stanton started at the dawn of theindustrial revolution
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And I am making instant and carried on for more than 200 years.
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happened in Stretton after it was prorogued. I've spoken in this place plenty of times about the struggles that our town centres face. The high street,
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online banking and frankly probably never will. Historic
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as true in the Midlands as they are on the coasts of Lincolnshire, of Yorkshire, Essex,Dorset, Cornwall, wherever, it's just as true inland as it ison the coast. I accept the
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My constituency is bounded
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is almost as far from the sea as it's possible to be
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miles away from my house, but still pretty close. But it's not like we don't have flooding, either. The flooding issues that
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Lord Bubba came in 2023. I spoke to people right across thein Ilkeston, in Leong Eaton and especially in Sandiacre, where many
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that there
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Church Wilne, which is being specifically developed to deal with particularly dirty water sourced from the River Trent.Indeed, the Aire itself, formerly flanked on both sides by heavy industry as it flowed through Mansfield, Ashfield, Amber
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incredible growth that they've had in Greater
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Manchester was actually all just bundled up in shiny towers in the city centre.
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But that's not what the evidence showed, Madam Deputy Speaker, suggesting that these columnists at the
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were perhaps not engaging with that very real, serious debate in good
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Because yes, while the political grow of growth in Greater Manchester may not have yet seen its reach to the veryedges of its metropolitan area
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in my community. I think it's quite simple, really, Madam Deputy Speaker. Some have observed that maps of
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tram network and the city has a more productive economy than the country as a whole. I know that where they've done incredible work in Stockport on densification,meaning there's more people in the same space living together, shopping and
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where their trams go where
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graduates in these subjects to fill them. The truth is a world away from our economy in the Midlands, where there's very little opportunity for a job in the creative industries and young people are thoroughly
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Does he agree with me that the Children's Commissioner report read for some very stark reading and if I take my own city of Portsmouth, we were the 12th worst place to be a child in the country, yetwas in the top 20 of being that in the country. So when we talk about red wall seats and deprivation areas, it's really important that the south east isn't just seen as one block, but actually there areelements of the south-east where there is high deprivation, and we were the worst in the country for 16-year-old opportunity.
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Yes, Dudley. I thank the hon. Member for taking intervention and for for looking atchildren and our young people and our opportunities
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turns to his speech just to a reminder in case he hasn't read the teleprompter. It is Coastal Communities (Health) Bull
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The fact, Madam Deputy Speaker, is that coastal communities have suffered for the same reason that post-industrial Midlands and North have. The economy
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And I and I will continue to make points about the health system within coastal communities. I thank my hon. Friend for her intervention.
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I believe the political choices that were made. The route to recovery for these places, whether you live next to the sea or far away from it, is economic growth, and I think that is as true in the
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an unreliable
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that have been cut time and time again. There's a lot more I could talk about, Madam Deputy Speaker, should I
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I just want to resolve my speech, Madam Deputy Speaker.
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with a brief note to say that I can't support the Bull as written because I agree ultimately with the Prime Minister. What we need is growth in every
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and across all of society. Our problems aren't created by the geography, even if they are reinforced
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Ultimately, the problem is that our economy and our health service has been imbalanced for too long.
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choices made by successive governments. I'm proud to be part of the government that recognises that fact and is finally striving to connect correct our nation's course, not pitting us against one
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Thank you, Madam Deputy Speaker, and I'd like to begin by thanking the hon. Member for North Norfolk for beginning for bringing forward this bill and forgiving the House the opportunity to debate on all sides of the question the health and well-being of our coastal communities. And I trust that the hon. Member for North Norfolkwill be reassured that as a Minister I understand this issue well and as a constituency MP for Birkenhead myself living rightnext to the edge of the country, on the banks of the River Mersey, proximate to the Irish Sea, I understand this issue very well.The government shares the concern that lies behind this bill, and we recognise that there are significantand persistent health inequalities in some of our coastal communities, and it's absolutely right that the Government addresses them. Though I must say, Madam Deputy Speaker, in listening to the debate, I am struck by some of the comments thatmy hon. Friend made about the various health inequalities that persist across our country, and I do
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Pulling us all together.
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with my friend for Errowash in his citing of the underlying economic circumstances that are the
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of health. There should be nothing inevitable about somebody experiencing poorer health or spending
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fewer years of their life in good health simply because of where they live. Yet in far too many communities, including coastal communities, poorer health outcomes sit alongside deep-rootedsocial and economic disadvan- disadvantage. These challenges are not new; they were set out powerfully in the Chief Medical Officer’s 2021 report on health in coastal communities, and the importance of place to our health has been rein-by the Chief Medical Officer's latest annual report on health in rural areas and in small towns, and in this House we all thank the Chief Medical Officer for his considerable work on this subject. That report is particularly relevant
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of the challenges it identifies will be familiar to Members in this place. It highlights the challenges of accessing and providing services across greater distances
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aging populations, workforce recruitment and retention, housing pressures and hidden debt.
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and importantly, it also emphasises that health and social care services need to be designed around the needs and circumstances of local populations. That matters because, in a moment, that matters because when we talk about health inequalities, we cannot simply be talking about differences in people's experienceof the NHS, as I said in a speech yesterday on the work that we're doing on social care.
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Wait, given that we've got limited time to hear a ministerial response and she's obviously got an interest in this subject, as do I, would she agree to meet with me or set me up with the relevant ministerial meeting to discuss Coastalinequalities further.
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Thank you. Thank you, Madam Deputy Speaker. As you know, I never refuse a meeting with any member of this house and have my have my surgery on Wednesdays if he would like to pop in. If he wants to talk about mentalhealth or social care. If he wants to talk about general health inequalities, then I would refer him to the Minister for Health Inequality. Of course, high-quality healthcare matters to all of us enormously.
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Our health is shaped long before we arrive at a GP's surgery or a hospital waiting room. It's shaped by the homes that we grow up and live in, by our education and the opportunities available to us, and as members on this side
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