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NHS Primary Care: Ageing Population

Volume 638: debated on Tuesday 20 March 2018

3. What steps his Department is taking to ensure that NHS primary care infrastructure meets the demands of an ageing population. (904461)

By 2020, investment in general practice will have risen by £2.4 billion, which is 14% in real terms, including an additional £680 million in infrastructure and premises in the last two years.

The Health Secretary knows how hard staff have worked at the Gloucestershire Royal Hospital to ensure that this year—in fact, in January—it was rated 15th out of 137 hospitals for its A&E performance, despite the intensities of the winter. He knows from his recent visit that all staff, and their co-operation with health services, as well as within the A&E, have led to this, but will he also recognise and do all he can to let Public Health England know how important it is that new capital expenditure is available in order to increase beds and to serve the demographics of an ageing population?

I was pleased and privileged to see the brilliant work that staff are doing in Gloucester when I went on that visit. Deborah Lee and her team deserve enormous credit for getting a 10% improvement in performance year on year to February. A capital bid has been put in by my hon. Friend’s sustainability and transformation partnership. It is a promising bid and I hope to be able to give him news on that soon. If it is successful, it will be in no small part thanks to lobbying by him and our colleague, my hon. Friend the Member for Cheltenham (Alex Chalk).

Research shows that access to GPs is now more difficult than it was five years ago, and in Warrington, we still have fewer GPs than the population would merit, putting more pressure on A&E. What is the Secretary of State doing to attract more GPs to areas such as this and to reduce the burdens on those already in the profession, so that they do not take early retirement, as many are planning to do?

The hon. Lady is absolutely right about how important is to increase the number of GPs. The most significant thing is what we announced this morning, which is five new medical colleges that are in parts of the country where it is particularly hard to recruit doctors. Our intention is that half the medical school graduates should be moving into general practice because it is so important.

Thanet enjoys an ageing population and I am pleased to be a part of it. We will be delighted to know that one of the five new medical schools designated by the Secretary of State today is going to be based in east Kent: the bid from the University of Kent and Canterbury Christ Church University was successful. It will not have escaped my right hon. Friend’s notice that the Christ Church campus is in close proximity to an A&E hospital— the Queen Elizabeth The Queen Mother Hospital—and we hope very much to see all the benefits very soon. Thank you.

May I just say to the hon. Gentleman that if memory serves me correctly, he was born on 20 August 1943, and therefore, he is really not very old at all?

I congratulate my hon. Friend on being born five years before the NHS was founded—a very short while ago. Kent is an area that, although it is the garden of England, has some profound challenges in its health economy. One of those challenges is attracting doctors to work in Kent and other more geographically remote areas, so I am very hopeful that this big new announcement for the University of Kent will be a big help.

The GP-patient ratio in my constituency is unacceptably high, meaning that many people cannot get a GP appointment when they need it and they are turning up at the A&E—not only creating additional pressure but costing more in the process. What is the Secretary of State going to do to make sure that outer-London boroughs such as mine get the GP support that they need, because frankly, the assurances that he has already given are not manifesting themselves on the ground in terms of practical results for patients?

I appreciate that there are pressures in the hon. Gentleman’s constituency. I think most hon. Members would say that there are pressures in their constituency when it comes to general practice, so what have we done so far? Let me put it that way. This year, 3,157 medical school graduates will go on to specialise in general practice, which is the highest ever, but we still have to do more to improve the retention of GPs who are approaching retirement.

Forgive me, Mr Speaker, if first of all, I congratulate you on a marvellous event this morning, celebrating 10 years on from your acclaimed report on young children’s speech and language and calling for a national strategy on that, which directly links into education and health. It was an excellent event, thank you. But of course, on to Taunton Deane. Tomorrow, I shall be very proud in this Chamber to be presenting my petition, which over 6,000 good people from Taunton Deane have signed, calling for a new surgical centre at Musgrove Park Hospital. They are not querying the quality of the healthcare given, but they are querying the facilities. I wonder whether my right hon. Friend would agree that this is a very deserving case for a new centre and for funding.

If these cases were decided on the persistence and strength of the lobbying of local Members, for sure my hon. Friend’s would be at the very top of the list. I have been to the hospital and heard about the issues from staff—it was a very good visit. She has campaigned persistently on this and I very much hope that we can give her good news because I am aware of how urgent the need is.

Not only was the hon. Lady present in Speaker’s House this morning, but her sister and distinguished speech and language therapist Rosalind Pow was present as well, so we had two doses of Pow in the course of a breakfast meeting. It was an unforgettable experience for all concerned.

I cannot compete with that, Mr Speaker. Back in November, I wrote to the Secretary of State about the increased service charges on GP practices. Ambleside surgery in my constituency, which serves an increasingly ageing population, faces a huge increase of £25,000—more than double—and the staff there fear they cannot keep the surgery going long term with that kind of increase. A ministerial written response in November did not mention Ambleside once, so will the Secretary of State commit now to intervening directly to guarantee that Ambleside will not have to pay this unjustified additional £25,000 a year?

I will re-look at the issue and the response that the hon. Gentleman was given. The issue is that there is unevenness and unfairness in the rates charged to GPs whose surgeries belong to NHS Property Services. We are trying to make this fair across the country, but we also want to make sure that no GP surgeries close.

With an ageing population, I, too, welcome the aim of integrating health and social care and developing population-based planning, as we have done in Scotland with health and social care partnerships, but the outsourcing of health service contracts to private providers in NHS England has led to more fragmentation rather than integration. Will the Secretary of State agree that we need to repeal section 75 of the Health and Social Care Act 2012 so that local commissioners can develop patient-centred services and not fear litigation if they do not put them out to tender?

We want to encourage the NHS to move towards more integrated services, and part of that is about contractual structures, but part of it is about funding, and I gently point out to the hon. Lady that 8% of the NHS budget in England goes to general practice and only 6.6% in Scotland, which is why there is an even bigger problem with GP surgeries closing in Scotland.

The many and varied new integrated care structures developing in NHS England have no statutory basis, yet in the future will control the entire health budget for a population. Does the Secretary of State accept that with another major NHS reorganisation we need debate and legislation in this place to get the structure and governance right?

In my first few years as Health Secretary, the message I heard loud and clear from the NHS was that it did not want a huge structural reorganisation, so we are very cautious about changing statutory structures. We want to encourage integration, but in time, if the NHS says it would like the statutory structure changed, we will of course listen.