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.