An ARC News Service report. – Amanda Livingstone Owen of Ravenseat in Swaledale gave a graphic description of the problems that hill farming families face when she spoke at the Rural Summit at Tennants Auction Centre in Leyburn on Wednesday, November 19. And neither she nor Linda Cork (retired local headteacher) wanted to see the Yorkshire Dales turned into a living museum or a Dalesworld theme park. Pete Dwyer (corporate director, North Yorkshire County Council) also spoke about finding solutions to the funding problems that rural schools faced. The provision of health services in rural areas was described by Dr Mike Brooks of Reeth surgery and Dr Charles Parker of Hambleton, Richmondshire and Whitby Clinical Commissioning Group. Richmondshire District councillor John Amsden asked about the ambulance response times.
Amanda Livingstone Owen (pictured above with her daughter Annas) described herself not only as a mother of seven but also a hill farmer – an occupation, she said, which had shaped the iconic landscape and topography of the Yorkshire Dales which so attracted tourists.
“We farm the land, work with the environment encouraging wild life whilst also managing the peaty boggy moorland that has become important on a global scale with its ability to reabsorb gasses.”
But farming is a dangerous professions to be in and one of her family’s main problems is reaching medical facilities. She, like many others in the Dales, measures journeys by the time they take rather than distance – half an hour to the nearest market town and two hours to the Friarage Hospital at Northallerton.
“The roads are the slower, narrow winding country roads that are, I can assure you, tortuous to travel when you are in the throes of labour. I’ve had one emergency C section, one very premature (baby) and five (delivered) before I reached the hospital.” So to add more time to that journey to reach the James Cook University Hospital in Middlesbrough was, she said, ridiculous.
“Now we are making that journey even more difficult. If there are complications during child birth or in other emergency situations time is the essence.” And air ambulances won’t carry pregnant women.
She recalled Mother’s Day in 2012 when they thought one of their children had meningitis. It had taken three hours and five minutes to reach Middlesbrough because the snowy conditions made it impossible for a helicopter to collect the little girl. Thankfully it wasn’t meningitis.
“Personally I feel that we’ve been left high and dry – not allowed to have a home birth as we are too far from the hospital and, having to set off for the hospital, knowing full you’ll give birth en route. Once there was a hospital at Catterick. There was a perfectly equipped fully function hospital at Northallerton complete with paediatric unit, special care baby unit and children’s consultant.” She asked if it was progress now that those services had been moved to Middlesbrough.
She related how Gunnerside and Reeth schools had been federated due to the falling number of pupils. There were 38 at Gunnerside in 1999 and only seven now. This was because property prices had gone up so much that local people couldn’t afford a house in the Dales. Many houses had been bought as second or holiday homes which were left empty in winter.
“The villages are then almost deserted. Swaledale is becoming a fine example of rural depopulation – a social engineering of sorts. A kind of natural selection is taking place where only the strongest people survive. Any weakness – either health wise or financial – and people do not stay.” Swaledale was becoming the playground of the rich, she said.
For the farmers there were additional problems caused by living in a mobile phone “notspot”. But they needed to access the internet to fill in VAT returns, log sheep and cattle movements, and even for their children to send their homework by email during inclement weather.
“What incentive is there for young people and young families to live and work here when the essential services are being constantly eroded away and the gap between what’s available to town dwellings and country dwellers is widening?”
“There is no doubt that we are blessed to live in such a beautiful place and to feel that the footsteps of our forebears echo in all that we do. But we can’t survive just on fresh air and a view. We are not a living museum,” Amanda told the Summit.
Linda Cork, who retired as headteacher of Gunnerside Primary School in July commented: “We are not trying to conserve what we have now because if that’s all we’re trying to do then we are in danger of creating some sort of theme park – Dalesworld – that gets toured by coaches and left behind at the end of the day. We need to create a structure for moving forwards. If you put this place in aspic it will suffocate and die.”
She described how Gunnerside and Reeth schools had been federated and a more informal alliance of schools in Swaledale created.
“The Dales’ schools provide high standards (and) we also provide locational choice for young families. The schools make it possible for people to plan for a life in our most beautiful rural areas and to be able to bring up their children in a setting where many of us grew up.”
She warned, however, that if one element of the infrastructure in rural areas was removed then all the others became less secure and less attractive to the next generation. This would lead to the communities being less viable.
The lack of affordable homes made it difficult not only for young families to remain in the area but also for staff to live close to the schools. What about a rural rebate on housing tax she asked, and she also wondered if there could be some sort of fuel subsidy to help towards the cost of those long journeys to hospitals or other facilities.
“I want to see what we all want to see – the Dales as a living, vibrant, growing community which attracts families to live and work here. And is (also) a hub for tourists and a renowned centre of excellence for crafts people and producers.” And so she hoped the seminar would provide an opportunity for people to make a commitment to work together to find local solutions.
Pete Dwyer, NYCC corporate director, pointed out that increasingly school funding was determined by pupil numbers.
“That’s what creates a challenge in rural areas,” he said. “We have campaigned nationally to ensure that there are changes in those funding formulas. The government has responded and allowed the introduction of a sparcity factor in local funding. “We do not want to see children travelling huge distances to access high quality education.”
The county council had found that teachers would not apply for jobs in rural areas unless they felt secure about the future of the schools. That security in rural areas had been achieved by forming partnerships, such as the federation of Gunnerside and Reeth schools, or through alliances.
Like many other speakers he emphasised that the way to continue to provide good services during a period of austerity and financial cuts was through partnerships and creativity.
Health care was a major priority for people, Dr Mike Brooks said. He has been running the GP practice in Reeth on his own for seven years and is also a voluntary doctor for the ambulance service, attending road accidents and other serious medical incidents.
He told the Summit that at his surgery patients didn’t have to spend hours on the phone trying to book an appointment for maybe two week’ s time but could just walk in and get seen.
“When you walk in you get addressed on a first name basis by people who know you. Your GP has seen you many times before and so you don’t have to explain your story over and over again. And you can leave the surgery with your medication and don’t have to find a pharmacy or wait for hours for it to be dispensed. You go home safe in the knowledge that you have been to a practise with a very high level satisfaction rate.
“We are fortunate to have very good working relationships with the consultants at Northalleton and Middlesbrough (hospitals). We also do email consultations not just with young people but with … silver surfers.”
He hoped in the future to carry out emergency paediatric treatment using a video-link with consultants and to provide some chemo therapy treatments at the surgery. He would also like to develop the surgery as a well-being centre.
“We want to bring care closer to people,” he said. And good health care helped to keep rural communities viable.
Coun John Blackie emphasised the need for proper health care provision in deeply rural areas. He stated that health care provided by numbers and “one size fits all” was not suitable for rural and deeply rural areas.
“Without the sort of service that Dr Brooks provides and without having hospital services reasonably close, there’s no future for any communities. I think it’s time that those in London realised that,” he stated.
Dr Charles Parker of the Hambleton, Richmondshire and Whitby Clinical Commissioning Group said that one of the CCG’s main priorities was to move care closer to people. The provision of health care had to be part of a lifestyle package which would encourage people to stay in the rural areas.
He added that the CCG wanted to “make sure that care is in the right place for you and not the most convenient place for the health service.” To do that the CCG wanted to see increased integration of services which would include social services.
He explained that the CCG bought health care – both hospital and community care – for the local population, but not the services of GPs or their surgeries.
He told the Summit: “We are committed to the Friarage Hospital as a hub for the rural area population maintaining an acute service at the Friarage, but maybe that will evolve. It may well be that we will meet people at the front door and then assess where is the best place for them to be treated. But that will be led by consultants.”
The ambulance response times were, he said, a priority. To do this ambulance crews could, when possible, take patients to GP surgeries rather than to hospital; and emergency ambulances were not being used to transport patients to hospital when there was a non-urgent request from a GP.
During question time Richmondshire District councillor John Amsden introduced himself as a community first responder (Carperby and Aysgarth team). He said that on two occasions when he had been called out as a first responder he had had to wait for 45 minutes or more for an ambulance to arrive. “To me that is unacceptable in a rural area,” he commented.
Dr Parker replied that they had been working very hard to improve response times and there had been a significant improvement especially in the last two years.
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