Healthcare in Rural Communities Must Be Local and Accessible

Rural communities are the backbone of our country, yet when it comes to healthcare, they are too often overlooked. Unlike urban areas, where hospitals and GP surgeries are clustered within walking distance or a short bus ride, our villages and small towns are spread across wide areas, with fewer people to support essential services. That reality makes delivering healthcare not only more challenging but also more expensive.

In Mid Bedfordshire, for example, my constituents rely on just nine main GP surgeries to serve the entire area, compared with 20 in the Health Secretary Wes Streeting’s constituency. The village doctor – once a familiar presence in our communities – is largely a thing of the past. Accessing healthcare means long journeys, lost time, and sometimes the simple frustration of a delayed appointment. Online services have been championed as a solution, but for many rural communities, reliable broadband or mobile signal is still out of reach.

When the Government announced plans for a neighbourhood health service as part of its ten-year health plan, I was cautiously optimistic. And from my conversations locally I know there was optimism in the healthcare sector too. At a glance it would empower people to get care close to home and reduce the pressure on hospitals, which could then focus on patients requiring specialist attention. Yet the details have tempered that optimism. A Government Minister has admitted to me that their definition of neighbourhoods cover around 50,000 people. In rural areas like Mid Bedfordshire, this simply doesn’t work. Such a large catchment would either split communities across urban hubs or force residents to travel many miles to a central location. Either way, the promise of local healthcare would remain unfulfilled.

Rural communities deserve better. Healthcare should not treat villages and small towns as peripheral to urban centres. Funding formulas that allocate resources strictly per head exacerbate the problem, particularly given that rural populations are ageing faster than urban ones. Nearly a quarter of rural residents are over 65, and their healthcare needs are often more complex. Yet these communities frequently lose out in the allocation of doctors, nurses, and support services.

The challenge is compounded by the recent centralisation of local healthcare decision-making. Here in Bedfordshire, our integrated care board (ICB) – Bedford, Luton and Milton Keynes – has been merged into a much larger ICB covering additional huge areas in Hertfordshire, Cambridgeshire, Peterborough. This mega-structure, serving 3.5 million people, risks diluting attention on smaller rural towns. In Wixams, a new town in my constituency, a GP surgery has been promised since 2007, yet progress has been slow. Under the new ICB arrangement, Wixams represents just 0.1% of the population, making it even harder for residents to secure the services they need.

It is not just a local issue. Across England, the reduction of 42 ICBs to 26 “super-ICBs” threatens to leave thousands of rural communities with less influence over their healthcare. While neighbourhood health services are a welcome concept, they must reflect the scale of the communities they serve. A rural neighbourhood should not be expected to function effectively with a population of 50,000; 10,000 would be far more realistic. Residents should be able to access care in their own towns and villages, not forced to travel to distant urban centres.

Equally, the connection between housing development and healthcare infrastructure must be addressed. Over the past decade, central Bedfordshire alone has seen more than 20,000 new homes built, with many more planned. Yet the infrastructure needed to support these communities – GP surgeries, health centres, and local services – has not always kept pace. The old promise of “build the houses, and we’ll deliver the infrastructure” is no longer sufficient. Communities deserve to see healthcare facilities in place as developments are completed, not years later, if at all.

A simple solution would be to ensure councils and ICBs can access developer contributions from the moment planning permission is granted, rather than waiting until construction is finished. This would guarantee that healthcare grows alongside housing, rather than lagging behind.

Rural communities face particular challenges: distances between services, ageing populations, and a shortage of doctors and nurses. These challenges are compounded by centralisation and by the one-size-fits-all approach to neighbourhood healthcare. It is time for policies that recognise the unique needs of rural areas, prioritise local access, and ensure that development brings with it the infrastructure our communities require. For too long, villages and small towns in Mid Bedfordshire and across England have paid the price of delayed or inaccessible healthcare. It is time that changed.