I beg to move,
That this House has considered Ampthill primary care and parking.
It is a pleasure to bring this debate here under your chairmanship, Mr Howarth. I spend many hours sitting in the Chair that you are in at the moment, so it is a pleasure and delight to be on the other side, representing Ampthill residents and GP surgeries. It is also a delight to have this Minister—my friend and constituency neighbour—answering the debate. It is worth putting it on record that he is not only one of the nicest and kindest MPs in Parliament, but someone who is absolutely deserving of his position. It is an honour to present this debate to him.
I would like to begin by discussing Ampthill. I hope that I will not disclose anything that I should not here, but my right hon. Friend and I have bumped into each other in my constituency on more than one occasion, not least when he was checking out the new Waitrose store opposite the area that I am about to discuss. I would like to set the scene by talking about the Ampthill surgeries and the problem we have, before I go on to some of the finer points.
Just off Oliver Street in Ampthill is about an acre of land, on which sit three GP surgeries, a fire station and a nursery and playschool. It is an incredibly busy area. Unfortunately, only a few months ago, for reasons that I do not fully understand, a car left one of the car park places and went through the windows of the GP surgery into the waiting room. There is a constant feeling of panic, anger and fear in the car parks. I myself have witnessed on a number of occasions cars not only mounting the kerbs, but mounting the kerbs—it is a very narrow kerb; there is limited kerb—where elderly people are walking. I was myself the subject of a road rage attack at the GP practice just a few months ago. There is nowhere for people to park when they visit the doctor, so people become very distressed. Many drive away, which leaves the GP appointments unfulfilled. Many just abandon their cars to get into the doctor’s practice, which causes chaos. Many people become very stressed and agitated, and start shouting not only at the receptionist, whose fault it is not that there are no car parking spaces, but at each other out in the car park.
At 9 o’clock in the morning, there is a stream of cars arriving to drop children off at the nursery and playschool. Around the outside of this area of land are the doctors’ practices, with their allocated car parking, but in the middle of this very congested area is the shabby prefabricated building that is the playschool. A constant stream of traffic is coming in to drop children off and going out again, leaving people with appointments from 9 am in a desperate state as they try to get to the surgery.
During the general election campaign, I was visiting my doctor’s surgery with a member of my family. I could not park, so I dropped my mother off to go in and was hovering around trying to get a place when a couple knocked on my car window and begged me to do something about the car parking. Then I was driving along and someone else did exactly the same thing. The fact is that I had already tried to do something. I had brought the situation to the attention of the local Central Bedfordshire Council. I set up a petition in the GP surgeries and was astonished that within no time thousands of people had signed the petition, which I will present to Parliament. People are desperately concerned that something very serious is about to happen in that car park area.
I ask the Minister whether, as part of the solution that I will come to, he will come with me to see the area so that he can understand what I am talking about, because I think it has to be seen to be understood. It has to be seen to be believed—how bad it is. He could talk to some of the reception staff, who are on the end of patients’ anger, upset and stress and have to answer to the doctors as to why people cannot get in for their appointments or blood tests—because they simply cannot get out of their cars.
The situation is exacerbated because the doctors’ surgeries in Ampthill are so good. The doctors are excellent; the reception staff are too. We all know the gatekeepers from hell who usually have those jobs in a doctor’s surgery. We do not have that in Ampthill surgeries; we have compassionate, understanding and extremely helpful staff in those surgeries. I think it would be good for the Minister to meet those staff and hear their story as well, because I will need his support to find a solution.
In their wisdom, SEPT—South Essex Partnership University NHS Foundation Trust—decided earlier this year to reallocate 20 district nurses to this incredibly congested area, so that it would be used as a base by those nurses, with their cars, even though there was nowhere for them to go. So an already very tense situation was made 20 times worse by 20 more cars turning up daily in the area. People are already afraid and an accident has already occurred, so for that to happen as well is exasperating for everyone concerned, staff and patients alike.
Some action has to happen, and soon. The status quo is not acceptable. I wanted this debate today because I wanted to put this on the record. I want it on the record, if something does occur in this area, that the problem had been noticed and people had been notified and that, on behalf of the doctors, staff and patients, I, Central Bedfordshire Council and others were trying to reach a solution to ensure that something did not occur.
There are a number of options. I will describe what would be the best scenario for this area, because the GP practices are not in the best condition. They are in shoddily erected, prefabricated buildings. People will know the kind of thing I am talking about; when a town is growing, infrastructure is hastily put in place. They are not the best facilities. The ideal solution would be for us to have a polyclinic—a new, purpose-built facility. We could amalgamate the three surgeries and have one new facility that provides enhanced services compared with what we have now. A number of patients, such as those needing INR—international normalised ratio—testing and other testing, have to travel to Bedford for services that, in this day and age, should be available at their GP practice.
The ideal solution would be a brand-new, off-site, purpose-built GP practice. That is what I would like to push for, because it is what Ampthill needs, and it needs it because it is growing. New houses are being built. It is a very popular, central destination in Mid Bedfordshire. It is very close to Flitwick train station. Interestingly, the patients who attend Ampthill surgeries come from areas in a 20-mile radius. They come from as far away as Wootton, Toddington, Flitwick and Barton-le-Clay. Patients from all over the area attend Ampthill surgeries. In fact, one of the people who are leading the campaign and part of the patient representative group is a patient who lives in Wootton. Because of the excellence of the GP practices, they attract patients from a wide area. The ideal scenario is for us to recognise what a good GP, primary care situation we have there, and to take that and move it to a purpose-built building.
Another scenario would be to demolish the shabby prefabricated building that is the playschool and move the playschool somewhere within Ampthill where there is not the constant congestion and traffic fumes all day long around the facility or the enhanced danger that comes from such dense traffic going in and out of the area. That is another solution—to move the children away. There are buildings in Ampthill that could be used in any of those situations.
The solutions are not easy, but no solution ever is. I have found, as an MP and in other aspects of life, that whenever anyone proposes an obvious solution to a problem, someone will always come along with 100 reasons why it cannot happen. Too often, people who would otherwise be required to put a great deal of imagination and effort into finding a solution simply say, “We can’t do that.” We must dispense with the words “We can’t do that, because” and look for ways we can do this. We need to come up with imaginative proposals, knock down a few barriers, chuck a few of the excuses out of the window and find a solution. I am concerned about the fact that too many people are treading water. Instead of meeting their responsibility to find a solution, they are finding excuses for continuing with the current untenable situation.
If anybody suggests as a reason for inaction that there is no popular support, I have a petition with the signatures of thousands of people, all of whom expect action. Ampthill residents expect something to happen. There has been extensive new development in Ampthill, from Fallowfield to Ampthill Heights, but most of the section 106 money from those developments went into education. I do not decry that fact; I simply point out that in Ampthill not everybody has children, but everybody needs to use the NHS facilities. The elderly do not have young children, but they are some of the biggest users of NHS surgeries. The GP receptionist told me that many people ask for late evening appointments so that they can avoid the pre-school traffic, because they think that parking will be less congested. Unfortunately, the situation is quite bad at that time of night, because that is when everybody comes out of work and wants a GP appointment.
The local feeling is that we need to find a solution, and a polyclinic would be an ideal one. More than anything, however, we need money. I know that NHS England has money from section 106 allocations that belongs to Ampthill residents. That money is sitting in NHS England. I am not sure exactly how much it is, but I have been told various amounts, from £8,000 upwards. It belongs in Ampthill, and it should be spent on primary care in Ampthill. There is no better cause to spend it on than the parking situation at the Ampthill surgeries.
Other people have to come to the table, including Central Bedfordshire Council and the GP practices. As fundholders, they should bring their allocation. The whole thing should not rest on the shoulders of the GP practices, Central Bedfordshire Council or NHS England, however; we need partnership working to find a solution. I have asked my right hon. Friend the Minister whether he would come and visit the surgery. What I would prefer is a meeting, with him, the fundholders, Central Bedfordshire Council and NHS England, and me, so that we can all work together to thrash out the solution we need for Ampthill, to make visiting the GP practice—something that nobody ever does willingly or happily—a less stressful, tense and sometimes turbulent affair. We must do that soon. I hope my right hon. Friend will agree to that, and I hope he agrees with me that it is a good way forward.
I also hope that my right hon. Friend might have some ideas of his own, and that he might be able to bring to the table something that will reassure the fundholders, the patients, the doctors, the receptionists and the councillors. I pay tribute to the councillors in Ampthill, who have done their bit to try to sort out the problems. I spoke to Mike Blair and Paul Duckett about the matter only recently, and I know that they have tried to do their bit, but they keep meeting a brick wall of: “We can’t do this, because—”. I hope the Minister will help me to bash down that brick wall and find a solution, so that we can work in partnership to resolve this difficult situation. Let us hope that if we do that, we can prevent a tragic and disastrous scenario of the sort that may result if we tread water for much longer.
It is a great pleasure to serve under your chairmanship, Mr Howarth. Some years ago, I canvassed for the Conservative party in your by-election. I have many happy memories of that time, not least because I had the opportunity to meet regularly almost all the Conservative voters in the constituency, none of whom prevented you from being here.
I thank my hon. Friend the Member for Mid Bedfordshire (Nadine Dorries) warmly for her kind remarks, and I congratulate her on securing this important debate. She was right about a number of things, including my knowledge of Ampthill, where I have indeed bumped into her. She has been an excellent colleague and partner in a variety of matters that affect Bedfordshire, and our two constituencies abut each other. I know Ampthill well because I regularly run in the park and use the tidy tip. The significance of that is that the main street to the tidy tip from my home in Wootton is, of course, Oliver Street, so I know it extremely well. In the world of the future, new technology will make it possible for viewers of our debates to see maps of areas that we are discussing. It would be easy to project a map into a televised debate such as this. However, as we are in a Chamber full of words rather than pictures, I can merely allude to that idea.
My hon. Friend is absolutely correct in her description of Oliver Street. It is a tight street, which is closely parked. Whichever direction they travel along the street, drivers will at some stage have to stop behind parked cars and allow traffic from the other direction to pass. In the area surrounding the surgeries, there is a cluster of buildings and some car parking arrangements that my hon. Friend has described well. I emphasise that I know the street well, and I shall be happy to respond later to her comments on the car parking problems.
I shall start by talking about GP services. My hon. Friend referred in a recent blog post to the growth taking place in Ampthill. She has described the primary care group as “the Cinderella of Ampthill” and said that it has had none of the recent investment or money associated with that growth. I want to address the issue of GP care being a Cinderella service and the question of investment in Ampthill. I pay a particularly warm tribute to all who work in primary care, not least in Ampthill, and in general practice: the GPs, the practice nurses and all others who work for patients. Primary care is the bedrock of the NHS, and although we are all familiar with what happens in hospitals, too often we seem to take for granted the service that patients receive from primary care.
My hon. Friend spoke about primary care in the widest sense, and I echo that. Primary care is much wider than general practice; it is all the day-to-day healthcare provided by healthcare professionals, and thus it includes such professions as district nurses, pharmacies, dentists and other ancillary occupations. Accordingly, as my hon. Friend has said, the trend is for the expansion of primary care facilities to be more than simply GP surgeries, and the Government have recognised that. Recently, in his first speech about general practice during this Government, my right hon. Friend the Secretary of State reaffirmed the Government’s commitment to the primary care infrastructure fund. That is a fund of about £750 million spread over the next four years, which offers practices the opportunity to seek investment in premises for development and the like. Such investment is sought by way of a competitive bid, and that is being taken forward in various waves. If the practices involved have not put in a bid, it is a matter for them. Clearly, £750 million spread across the country will not solve everyone’s problems, but it recognisees the need for some practices to seek to grow and for their premises to have the sorts of ancillary functions that we will all start to take for granted as, hopefully, fewer people go to acute hospitals for treatment that can be carried out elsewhere. The modern practices of the future will do that.
Easy access has to be part of that future. There is no point in seeking to do minor ops at the various ancillary services provided in the community if people cannot park. My hon. Friend spoke about the wide range of places from which these practices draw their patients. Ampthill has a population of about 6,000, but the practices have a total of some 20,000 patients, so the majority of those patients will clearly not be walking but coming by car. It is therefore necessary to ensure that adequate facilities are available. Ensuring adequate parking will be important for the premises of the future.
Primary care probably has the widest scope in healthcare, and it includes patients of all ages, from every socioeconomic and geographic origin and with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Some 90% of all NHS patient contacts take place in general practice, which is why it is important to ensure that modern general practices, and the practices described by my hon. Friend, have everything they require. What many of us think of first when we think about the primary care profession in this country over recent years is that it has developed a wide skill base and body of knowledge. GPs provide a complete spectrum of care within their local community for problems that combine physical, psychological and social components. They attend patients in surgery and primary care emergency centres, if clinically necessary, and they visit patients’ homes. GPs must be aware and take account of all factors when looking after patients.
In his recent speech, the Secretary of State made it clear that he recognises that GPs need to call on an extensive knowledge of medical conditions to be able to assess a problem and decide on the appropriate course of action. They must know how and when to intervene through treatment, prevention and education to promote the health of patients and their families. Recently, the Commonwealth Fund, an independent institute based in the United States, declared that the NHS is the best healthcare system in the world. Although many people assume that to be because of our acute hospital care, the bedrock for the research on which that determination was based turned out to be family care and general practice, which is a further reason for addressing the needs of general practice—in the widest possible sense, from availability to ease of access—as my hon. Friend has done.
Most GPs are independent contractors to the NHS. That independence means that, in most cases, they are responsible for providing adequate premises from which to practise and for employing their own staff. As we have heard from my hon. Friend, GPs are determined to do the right thing in relation to parking. It is noticeable that the three surgeries that serve Ampthill’s population of 6,000, and patients from the wider area, are located within yards of each other in the middle of town. There is already parking for staff and patients, and there is a bus service with a bus stop nearby. Oliver Street is a main through-route in Ampthill. It is busy and narrow, and the presence of a fire station, an ambulance station, a nursery and a school in the vicinity all contribute to heavy traffic, particularly at certain times of the day.
I missed out a point that I want to put on the record. A fire engine was recently prevented from leaving the fire station because of congestion caused by cars coming in and out of the pre-school off Oliver Street, which is near the practices. A fire engine being trapped and unable to leave a fire station owing to traffic density is not good.
There are things that we are able to do and things that we are not able to do. The general traffic issues in the town are, of course, a matter for other authorities beyond the Department of Health, but my hon. Friend makes a perfectly fair point.
In the Houghton Close area, there is pressure on parking for both practice staff and patients. GP practices, as independent contractors, are responsible for providing adequate premises and for employing their own staff. In passing, I want to say a word about the way in which such practices look after their patients, which is entirely relevant. Good things are happening in primary care and in Ampthill. The key test of that is the GP patient survey, which gives patients a chance to comment on the performance of the practice where they are registered. Patients say that the three Ampthill practices—the Oliver Street, Houghton Close and Greensand surgeries—have a good story to tell. Overall, across all measures, the three practices are averaging around 90% satisfaction. Most of us would love to have that degree of satisfaction, although, Mr Howarth, you have that in your constituency, as indeed does my hon. Friend. No score of the practices is below 84%, and the scores are much higher in many domains. For example, all of Greensand’s scores are 90% or above, with 96% reporting satisfaction with their overall experience of the surgery. It is therefore clear that today’s debate concerns what patients agree are good, all-round, high-performing practices. While addressing their needs, I congratulate each practice on its commitment to providing the best service to patients, of which, to a degree, the subject of this debate is an element.
There is pressure on parking in the Ampthill area, which is why there have been recent moves, encouraged by my hon. Friend, to consider what can be done about it. In matters such as land purchases that affect the public sector, it is often advisable to take advice from the district valuer. The Ampthill practices have had discussions with the town council about purchasing a grassed area next to the fire station which they hope to convert to additional parking. NHS England is prepared to contribute part of the cost. However, the decision on whether to buy or sell the land is not for me or anyone in Whitehall; it properly belongs to the prospective purchasers and the landowners.
The town council has made a request to NHS England to fund the purchase and set up a car park to increase parking capacity in the area. The land, once purchased, would not be for the sole use of the practices but would be open to all users. The estimated cost of the land is between £8,000 and £9,000. NHS England has agreed to fund some 25% of the cost, which is believed to be a fair portion of the practices’ proposed usage of the area, with no commitment to recurring costs. NHS England was also asked to provide funding for maintenance of the parking facility. Although NHS England is prepared to contribute to the purchase cost, it is not prepared to fund the maintenance costs because it will not be the dominant or exclusive user.
My hon. Friend made a fair point about the recent addition of some 20 practice nurses in the practices at the request of NHS England, which carries a certain amount of obligation. I therefore hope that we will be able to go back and see what more can be done. In February 2015 the town council’s planning committee considered the matter and advised the practices to discuss it directly with the fire service’s landowners. I will therefore encourage the continuation of that process. We have discussed the matter further with NHS England, which is prepared to think again about the costs involved. Following this debate and the representations we have made, the way is open for my hon. Friend to further discuss the situation directly with NHS England, the town council and Central Bedfordshire Council. I am grateful for the advice of the leader of Central Bedfordshire Council, James Jamieson, to whom I spoke last night. I am pleased to accept the invitation to visit the area more formally, which will give me a great opportunity to speak to the practices involved, to see the situation on the ground and to consider whether there is anything further we can do.
Although this matter is not fundamentally the responsibility of the Department of Health, I acknowledge our interest in ensuring that these practices have what they need to provide what is obviously an excellent service to constituents, to consider the opportunity for purchasing proper parking facilities and to help and liaise in some of the discussions that will take place under other people’s auspices. Finally, I will have a chance to see the situation on the ground, rather than passing through on the way to the tidy tip or another run in glorious Ampthill Park.
I thank my hon. Friend for bringing this matter to the House today. Thank you for your chairmanship, Mr Howarth.
Question put and agreed to.