Liberal Democrat MPs Warn 10-Year Health Plan Risks Penalising Rural and Coastal Communities

​Liberal Democrat Primary Care Spokesperson Helen Maguire MP, alongside many of her parliamentary colleagues, has formally written to the Health Secretary expressing severe concerns that the government’s proposed 10-Year Health Plan will leave rural and coastal populations with degraded healthcare access.

​The MPs highlighted recent research from the think tank Policy Exchange, warning that the government's upcoming framework for "neighbourhood health" could exacerbate existing regional inequalities.

​"We are writing with great concern about recent analysis by Policy Exchange which suggests that the government's framework for 'neighbourhood health' risks leaving rural and coastal communities with fewer services, longer journeys and less choice," the letter states. "We are particularly alarmed at the prospect that rural and village GP surgeries may be shut under these plans."

​While the Liberal Democrats support the overarching ambition of bringing care closer to home, the signatories argued that the current framework relies on a fundamentally urban blueprint that fails to account for regional geography.

​"The report shows that the 10-Year Health Plan assumes a country of urban towns and cities, where 'local' means a short bus ride," the MPs wrote. "In much of rural and coastal England, where many of our constituencies lie, 'local' can mean dozens of miles. Organising primary care around populations of 50,000, as the plan describes, entails truly vast distances, collecting up towns and villages far apart and poorly connected from each other."

​The letter highlights critical disparities detailed in the report regarding healthcare distribution and funding in remote areas, noting that:

-​Staffing Shortages: Coastal communities have 14.6% fewer postgraduate medical trainees, 15% fewer consultants, and 7.4% fewer nurses per patient than the national average, despite serving older and less healthy populations.

-​Flawed Funding Formulas: Existing allocation mechanisms fail to account for the extra complexity and operational costs of rural and coastal general practices.

-​Incentive Disparities: High-Cost Area Supplements compensate healthcare staff working in expensive cities, but offer no financial incentives for staff taking roles in remote or coastal areas.

​The MPs cautioned against administrative restructuring that could inadvertently shrink local care access, writing, "Our constituents, whether they live in a village or a town centre, should not receive a lower standard of care because of a postcode lottery. Rural surgeries are closing even as their populations grow, and a framework built around populations of 50,000 to 250,000 risks becoming centralisation by another name."

​To mitigate these risks, Maguire and her colleagues called on the Health Secretary to deliver three key commitments:

-​Pledge that rural medical services will not be defunded or closed under the new proposals.

-​Publish a full rural and coastal impact assessment of the 10-Year Health Plan and the neighbourhood health model.

-​Review NHS funding formulas, including the outdated Carr-Hill formula, to ensure allocations properly reflect rurality alongside deprivation and clinical need.

​The letter concludes with a direct appeal for equitable healthcare provision: "Rural and coastal communities are entitled to the same quality of care as anyone else. Recognising their circumstances is not special treatment; it's just fairness."