Rural local authorities spend a disproportionately higher share of their budget on providing social care than their urban counterparts, MPs warn.
A three-year investigation undertaken by the All-Party Parliamentary Group (APPG) for Rural Health and Care and the National Centre for Rural Health and Care has found stark levels of inequality between rural and urban areas when it comes to health and social care services.
It found that those living in rural or coastal communities – around a fifth of England’s population – have poorer access to health and social care services than those living in towns and cities despite the ‘social duty to promote equality’ embodied in the NHS Constitution.
One of the major obstacles to ensuring that rural health and social care services are on a par with those delivered in urban areas is a shortage of good quality data, the investigation found. What the APPG calls ‘inappropriate data collection methods’ in rural areas has resulted in these places being underfunded.
As a result of a lack of sufficient funds, rural local authorities are forced to spend a disproportionately higher share of their budget on these services and local council taxpayers have to fund more costs than their urban counterparts.
‘The road to better healthcare for rural communities starts with a more accurate and reliable understanding of rural circumstances and experience – and accurate data is essential to inform effective rural planning,’ the report says.
‘Policymakers too frequently underestimate the challenges and the costs of living in rural areas. This is in part due to the way we collect data. The criteria, although relevant to more densely populated communities, are inappropriate for more sparsely populated localities and do not reflect rural needs. This distorts the situation in rural communities, with residents often appearing to be more affluent despite facing lower wages, and higher living costs.
‘The consequence is that the basis for planning is flawed, impacting on the formulae for funding. Evidence received by the Inquiry confirms that current funding arrangements need to be urgently addressed to account for the true cost of rural health services.’
According to the APPG’s inquiry, which was undertaken with the National Centre for Rural Health and Care, the urban-rural health and social care divide is also made worse by a shortage of professionally qualified staff, limited public transport, and poor broadband and network access in rural areas.
Commenting on the findings, Anne Marie Morris MP, chair of APPG on Rural Health & Social Care said: ‘The events of the last 18 months have led to a large number of people discovering the attraction of rural living and the lifestyle that it offers. Yet for the newcomers and part-time rural residents who have become full time converts, the realities of rural health provision will have become very apparent.
‘Without clear changes in policy direction and decision-making, the situation will move from urgent to critical. As we have seen, undiagnosed and unaddressed health conditions usually end up resulting in higher costs, poorer health outcomes, poorer economic opportunity and, in every sense, a poorer community.
‘Therefore, policy makers need to focus on how we design, commission and deliver health care in these areas. Our rural communities deserve better health and care. This report shows how we can make this happen.’
Professor Richard Parish, executive chair of the National Centre for Rural Health and Care and the report’s author, commented: ‘The health care needs of rural communities have been side-lined for far too long and the Government can no longer turn a blind eye to the needs of almost a fifth of the population.
‘There is clear evidence that change is required. We must provide tailored, person-centred, community-based approaches to health and care services in rural communities. Without clear changes in policy direction, the situation will move from urgent to critical.
‘The current “one size fits all” model is ineffective and inefficient. If we are truly serious about “levelling up”, we must ensure that rural residents have the same access to timely, quality services as their urban counterparts. The solutions are there, they just need to be recognised and properly funded.’
Graham Biggs, chief executive of the Rural Services Network, said: ‘We very much support the conclusions of this report. The acknowledgement that infrastructure concerns such as those relating to transport and digital connectivity have significant impacts on rural health, social care and wellbeing and increase vulnerabilities and inequalities is very timely and very welcome. The issues here are not just for the DHSC [Department of Health and Social Care] but are cross-government, fundamental to levelling-up and need urgent attention.’
