Dr Simon Opher
MP for Stroud · Labour · United Kingdom
“We must not say that things are getting worse, because I believe they are slowly getting better. As so many have said, we need to fix social care. We could have a system whereby the community is responsible for a patient as soon as they are ready for discharge.”
“I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for securing this debate and for her years of work in the A&E at St George’s. Emergency care is in crisis in the NHS, and corridor care is just an overspill because we cannot cope. That is because we are doing a few things wrong that we could remedy. I work as a GP.”
“That is absolutely true. We need to look at all the ways of reducing demand on GPs and, therefore, on A&E departments—that is what my speech is totally involved in—and pharmacies have a really good role to play. There is another thing here, which was noticed in the doctors’ strike.”
“We also need GPs to be assessing emergencies up until 10 o’clock at night to relieve the pressure on A&Es. There are a couple of other things. I have said about getting more experienced doctors involved earlier in the process, but we also need to invest in scanners—so many people in A&E are waiting for tests before they go home.”
“Dementia fluctuates, so just because someone has seen a slight increase in confusion, that does not mean that they need a whole batch of tests. We need to treat dementia more holistically. Polypharmacy—that is old people on loads of drugs—causes about 10% of admissions, so let us reduce that. We need good end-of-life care.”
“In Stroud alone, in four years, the number of over 90-year-olds went up 29% in just that short period of time. We have an enormous cohort of very elderly and frail people. Secondly, as we have heard, we have a lack of beds due to delayed discharge—I will not say any more on that.”
The complete record
Every one of 482 lines we hold for Dr Simon Opher, in date order, each linked to its source. Free to read, in full, without an account. Page 10 of 10.
“Sorry. I did get rather angry there, and I shall not get angry any more. Let me talk about GP access. We need to get doctors, not receptionists or 111, to perform triage, and we need to start thinking in a different way. We do not want a protocol-driven NHS; what we need is a genuine doctor-patient relationship. We also need to develop neighbourhood—”
“Okay. I worked in general practice for 30 years. There is always mitigation for tax changes, and I have no doubt that the Government will look after GPs.”
“We must fix the foundations of care and use the new funding to ensure that more patients are cared for at home. Difficult decisions are being taken, but all of us on both sides of the House want to see the NHS become the best in the world again, and this Budget starts that process.”
“I have no doubt. I would like to finish my speech, if I may. We need to invest in neighbourhood health centres. In Suffolk, Dr Tim Reed is developing a genuinely holistic service, which will save money and increase productivity in mental health provision and among paramedics. This is something that we need to explore much more. I spent 48 hours with a loved one in Bristol Royal infirmary’s A&E department, and I saw the huge pressure that it was under. I notice that Dr Simon Laing is using innovative ways of going out with paramedics, keeping patients at home and working with paramedics in his department. That is the type of adaptation we need in the NHS. This Budget begins the process of transforming the NHS and will reward NHS staff up and down the country, who continue to deliver excellent unscheduled care.”
“I will make a little plug: they tend to die 10 to 20 years earlier than other people and we must promote their physical health. The other area is anxiety and depression. We have 8 million people in this country on antidepressants—selective serotonin reuptake inhibitors—and at least 2 million of them are trying to get off. We need to ensure we do not over-medicalise mental health. I was pleased to hear what my hon. Friend the Member for Ashford said about mental wellbeing and mental health. We all get a bit pissed off sometimes—that is normal for humans—and it is extremely important that we do not conflate that with mental ill health.”
“On World Mental Health Day, I am wearing this slightly ghastly yellow tie. May I also do a little promotion? In room M in Portcullis House at 3 o’clock, at the end of the debate, we have some young people, through YoungMinds, telling us what they think of the service. It is really important, particularly with young people, to make sure that we develop services that they want and that we do not dictate. I am still a practising GP in Stroud. More than 90% of mental health consultations take place in primary care and more than 40% of GP consultations concern mental health. I am sure the hon. Member for Hinckley and Bosworth (Dr Evans) will concur with me on that front. I would like to divide mental health into two sections. There is serious mental illness, which is serious and enduring, affecting about 130,000 people in this country.”
“Young people’s social prescribers are very effective and tend to de-medicalise things that can be supported in the community. I am really impressed that we are going to get 8,500 more mental health workers. I am also impressed by what they will be doing in schools. We need to improve the physical health of people with serious mental illness, reduce the number of SSRI antidepressant medications, and promote social prescribing, the arts and community care in our mental health services.”
“There is quite a lot of evidence about promoting maternal and infant mental health, and also about parenting and bullying at school. Using arts and culture is an incredibly strong way of improving mental health. I was impressed with what my hon. Friend the Member for York Central (Rachael Maskell) said about the community basis of mental health treatment. For many lower-level conditions, there is no need for consultant-led care. Support that takes place in the community costs much less and can be really effective. The CAMHS waiting list is appalling, and we have a crisis with SEND and delays with education, health and care plans. We do not have enough educational psychologists either. I want to stress what my hon. Friend the Member for Ashford said about care co-ordinators.”
“Absolutely; I fully agree with that. I want to make a couple of comments about the state of mental health services, for which there are extraordinary waits: a patient of mine had to wait six months following a suicide attempt. That is simply not good enough. In Stroud, we have to wait four years for neurodiversity assessments because we do not have enough resource. In my opinion, we need to move the resource into the community. I also support what my hon. Friend the Member for Ashford said about health and education. We need mental health support teams in our schools, and we must spread SEND provision evenly. The Under-Secretary of State for Public Health and Prevention is with us, so I want to talk about the prevention of mental health issues.”
“Although I support the principle of habitat creation and acknowledge the benefits of the salt marsh, does the Minister share my concern that EDF’s application to modify Hinkley Point C’s consent order seems like an unacceptably high price for an environmentally unique habitat to pay?”
“I thank the hon. Gentleman for all his detail and his excellent summary of exactly what is being proposed in Arlingham. The proposal was put to the people of Arlingham, they had a large meeting on Monday evening and, almost universally, there was a feeling that this was not a good idea for people there or for their landscape. Many of the reasons that the hon. Gentleman has put across are the same in Arlingham. It seems rather strange that the Arlingham site and salt marsh will somehow compensate for or mitigate the predicted loss of about 182 million fish; I do not think there is any way we can say that those two match each other.”
“There could be on-call systems for these stand-alone units, so a second midwife does not need to be present if they are available to be called in. I have talked to midwives about that, and they seem happy to run that type of service. We also need a commitment from the ICB and the Gloucestershire Hospitals NHS foundation trust to reopen all six post-natal beds at Stroud maternity hospital.”
“We must get those post-natal beds open, so I am also due to meet the maternity and neonatal voices partnership, which is a crucial agent that we must talk to. In summary, we need to train and, crucially, retain more midwives, because we have trained quite a lot of midwives who have almost immediately left the profession, as the hon. Member for Cheltenham was saying, because of stress. We need to secure a better working arrangement for them, and I look forward to my hon. Friend the Minister outlining plans to train thousands more midwives. We need to review CQC safety and make sure that the stand-alone nature of midwife units is fully understood by the CQC. We also have to make midwife working much more flexible.”
“This is not about covering the organisation and making that safe; it is about making the mother safe, so I would iterate that as well. There is something else that we have been doing. The League of Friends at Stroud hospital in general and at the maternity hospital is fabulous and has been providing extra services for post-natal and antenatal mums for some time. We now have an interim plan whereby we are going to open a sort of day hospital in the maternity unit so that at least mothers can come and have a bath while someone else looks after their baby, for example, and they can receive advice from health visitors and midwives. That is an interim plan. I do not want to say that it is a good replacement.”
“For example, postnatal beds are being closed because it insists on having two midwives on the unit at all times; that makes it safe. However, closing the post-natal beds means that all these mothers have to go home. Are they safer at home or are they safer at hospital, with maternity care assistants and other nursing staff? I would say that the safety of the mother is better served with those post-natal beds open, even if there is just an on-call midwife as a second midwife. I want to slightly question the logic of the CQC—we must go back to it—so one of the things that I will do after this debate is write to the inspectors and arrange a meeting with them, because we must consider the safety of the mother and the child first.”
“It is about making sure that the baby and the mother bond properly and that breastfeeding starts properly. It is about making sure that they have a couple of days away from, perhaps, a number of other children and properly bond and that mothers learn how to look after babies. A lot of my colleagues say, “Well, post-natal care, we don’t really need that,” but we do need it. If we lose it, it will cost the country more, but it is also part of the whole maternity service. That is the first thing I would say. Secondly, the people at the CQC have stipulated various things. The CQC is about safety, which none of us can argue about. However, some of its decisions, I feel, do not make sense and all they do is give safety to the organisation and not to the mother.”
“That is unusual in this country, and it is a shame it is unusual, because it is a really good place to have intrapartum care, so it is something that I am really trying to promote. We have 1,000 live births in Stroud a year, and at the moment only about 300 take place at Stroud maternity unit, but as I have said, there are lower levels of intervention and there is increased maternal satisfaction. For that reason, we must get these beds open again; they have been closed since 2022. I want to make a few points about post-natal care, because often people say, “Oh, it’s a luxury; we can’t really afford it.” It is not a luxury. There is very good evidence that for certain families, certain mothers, good post-natal care saves a huge amount of money later on.”
“Either mothers go there for their post-natal care or they have to go home and have a community midwife. The last part, I always think, of the whole maternity service is the eight-week check of the baby by their GP. I have done thousands of those checks in my life, and it is one of the best things I ever do. The GP can check babies for problems and talk to mums about not sleeping and all the other issues. That is the whole, rounded nature of maternity care. I now want to talk about Stroud maternity, because that is what I know about most and what we are missing most. First, it is a very much loved and valued service in Stroud and we are missing the six closed post-natal beds. As I have said, it is a stand-alone, midwife-led unit.”
“Equity and equality also seem to have been lost from the discussion recently, and we need to get them back into the decision-making process. Maternity care is actually a longer process than just where someone gives birth. I will outline where those interventions take place. Pre-conception and antenatal care tends to be done in GP surgeries by community midwives with the help of GPs. Intrapartum care can be done at home—a small proportion of people do give birth at home—or in midwife-led units, such as Stroud maternity, or in either midwife-led or consultant-led units, such as in Gloucester Royal and Cheltenham. They are the possibilities. When it comes to post-natal beds, the only choice at the moment is Gloucestershire Royal; there is no other option in Gloucestershire.”
“Friend the Member for Gloucester (Alex McIntyre) said, midwife-based units have lower levels of intervention and better outcomes for babies. As many hon. Members have said, the key problem here is the lack of midwives. We should not shy away from that, but I also want to talk about a number of other issues. Something that seems to have been missing from the discussion is women’s choice over where they give birth—we seem to have reduced that choice to just Gloucestershire Royal hospital. Although Stroud maternity unit is open for intrapartum care, it does not have post-natal beds, so women are generally choosing it less often. That is a pity, because it is a fantastic place to give birth and has a low intervention rate.”
“I thank the hon. Member for Cheltenham (Max Wilkinson) for calling this debate. Maternity care in the Stroud area has been a big issue for the past couple of years in particular. I have been a GP for 30 years, and I have helped with antenatal and post-natal care and, indeed, intrapartum care for six months, which was the hardest work I have ever done in my life. I also delivered my second daughter in a Worcester hospital. I know and have worked with fabulous midwives, who are the absolute key to maternity services, as we have been discussing. Doctors are occasionally called in for other reasons, but midwives run maternity services; they have to be central, and they have to make their decisions around women. That is one of the reasons I promote Stroud maternity unit: as my hon.”
“I thank the Secretary of State for his really rapid action to reach our 100% sustainable goals by 2030. It has developed a real excitement in this country, and the people I speak to are genuinely behind this action. In Stroud, we are developing a community energy programme of putting solar panels on every school and public building that agrees to it. What steps is he taking to support solar on schools and public buildings, and can he ensure there are no barriers to progress?”
“Sorry. We have experienced a lot of problems with cross-border rural buses in our area. The hon. Lady mentioned local authorities. If there are two local authorities, it creates enormous problems. In Wotton-under-Edge, we have just lost the 84/85 bus service because we cannot get agreement from all the different local authorities to fund it. That is putting a severe strain on rural populations. I would ask for that to be considered.”
“It is like a fresh wind has come in.” I feel that offers a real opportunity for us to deliver real change in this country. My father is 90. He was going to be here today, but he could not make it, which is really sad. He has been a lifelong socialist and Labour party member. He said in 2019, “I will probably never see another Labour Government,” but he has got to see one. Let us make this work and work hard to deliver renewable energy, so we can bring down the cost of power and change the whole environment of the country.”
“We have poets in nursing homes, and we started prescribing allotments. These non-medical prescriptions are crucial, and they save the NHS money, because people realise they do not need medicine to make them better. The arts are crucial. We must support this country’s world-class arts sector, and we must use it to make ourselves better. I will come to a conclusion. When I first arrived in the House, I was talking to some of the wonderful parliamentary staff who looked after new MPs so well. One of them said, “It is strange, because it is like there has been a generational change in the Commons. A wind has blown through the Commons and replaced what we had before with much younger Members”—not me, by the way—“and many more women. It is really ethnically diverse and there are LGBT people as well.”
“I worked in May Lane surgery for so long, and I praise the doctors, the nurses and all the reception staff for continuing to deliver extraordinary care to patients. General practice is delivering extraordinary care throughout the country, but we are in a certain amount of crisis. We have very low morale, and everyone is complaining about not being able to get a GP appointment, so I am proud that this Government will fix general practice by investing, innovating and making sure that patients receive the service they received in 2010. Another thing I would like to say on innovation is that, about 25 years ago, I introduced an artist in residence at my surgery to treat patients with mental ill health, and I managed to prove that it was incredibly effective. We then expanded into green prescribing, getting people to take walks.”
“Although I do not condone their protests in any way, I ask the Home Secretary to review their really excessive sentences, and I ask organisations such as Just Stop Oil to get behind us. We are the greenest Government this country has ever seen, so will they stop protesting and start building with us? Community is really important in Stroud. We have community hubs throughout the constituency. One of the best is GL11 in Cam, run by Indigo Redfern. Its volunteers look after vulnerable people. We have the country’s oldest community agriculture scheme, and we have a big scheme that buys community shops. When pubs close in little villages, we buy them, too. We are also looking at buying land to protect it for people to use.”
“Dale Vince built the first wind turbine on Tinkley Lane in 1996, and there is a lesson there, because there was incredible local opposition to it for years. People did not like it, but now it has come to be accepted. This is the future. Many of us have spoken about community energy, which we have been developing in Stroud. We now have six projects. Waitrose will have solar panels on its roof, and we are going to cover the hospital with solar panels. There is a scheme to put solar panels on every public building, which will save having to put them on farmland. I recommend such schemes. A number of my constituents are currently in prison for climate activism.”
“He was in Berkeley in my constituency, and he discovered vaccination. He saved the most lives in history, so we must honour him. Vaccination is transformative for health. One of the big benefits of the pandemic is that we developed mRNA vaccines, which in the future will be used to treat cancer. This new therapy is really exciting. Stroud is also home to cutting-edge companies, including Renishaw in the engineering industry. Ecotricity, owned by Dale Vince, has been at the cutting edge of sustainable energy for many years. We also have the fantastic Forest Green Rovers, the world’s only carbon-neutral football club. They are also vegan. Sadly, they were relegated from the football league this year, but I promise they will be back. I hope they will be, anyway.”
“He said, “First of all, both of you have surgeries, don’t you?” I thought about this more, and I thought about what I tell the doctors I train: “As a GP, you have to know the first three things about everything, which is true for MPs as well. You do not have to be an expert on anything, but you have to know a little bit about everything.” I have certainly learned a lot about that. Both GPs and MPs also need to be embedded in their community. But probably the most important thing to being a good doctor and a good MP is listening, not talking. The best doctors and the best MPs are the best listeners. Stroud is the most beautiful area, and its hills and valleys were made famous by Laurie Lee in “Cider with Rosie”, which Members may have read. A previous GP in the area, about 200 years ago, was Dr Edward Jenner.”
“She also squeezed the last Government into introducing what was probably their best bit of legislation, which was about childcare. This Government are continuing that and making sure that we deliver it. People who knew Siobhan will know that she also had a lot better hair than I do. [ Interruption. ] Thank you very much—I will move on hastily. I would also like to pay tribute to my Labour predecessor, David Drew, who was probably the best constituency MP I ever met. He is still very well loved in the area, and is still involved in local politics. He has given me lots of pieces of advice. One of them is to be yourself, which is good advice for all of us. I thank him for that. My father actually said that there are quite a lot of similarities between being an MP and being a GP.”
“Thank you, Madam Deputy Speaker. I thank the hon. Member for Waveney Valley (Adrian Ramsay) for his support for this really exciting piece of legislation—one of the most exciting in our manifesto. I am delighted to be making my maiden speech during a debate on renewable energy. Stroud has been a centre for sustainability and the environment for many years. I thank my constituents for supporting me. I have been a GP in Dursley, which is part of Stroud, for 30 years. I have looked after my patients there through thick and thin, through the most heart-rending moments and through the most joyous moments, and it has been an absolute privilege. To be honest, I slightly miss them in this place. I would like to pay tribute to my predecessor, Siobhan Baillie. Siobhan was always so cheerful and positive, and I really admired her for that.”