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Primary Care

Volume 746: debated on Tuesday 5 March 2024

8. What assessment she has made of the adequacy of primary care provision in rural communities. (901802)

We have met our manifesto commitment to deliver a record extra 50 million GP appointments annually. Our primary care recovery plan addresses increased GP access and expands community pharmacy services nationwide with Pharmacy First. Our NHS dentist reform plan also allocates resources for 2.5 million appointments, targeting rural and coastal communities.

I thank the Secretary of State for her response, and I thank the Minister for Health and Secondary Care, my right hon. Friend the Member for Pendle (Andrew Stephenson), for visiting the community diagnostic centre and minor injuries unit at the Herts and Essex Hospital yesterday and all the fantastic staff there.

Frontier Estates committed to building a GP surgery as part of the wider Stortford Fields development. However, citing inflated build costs, it now questions the viability of the plans despite months of negotiations and efforts by the local NHS to find a solution. Will my right hon. Friend work with colleagues in the Department for Levelling Up, Housing and Communities, with whom I have already met on this issue, to ensure that Frontier really engages with the process and builds the surgery it promised my constituents?

I congratulate my hon. Friend on the enormous amount of work she has done in her constituency to secure that community diagnostic centre. We have rolled out some 160 or so of those centres across England —we want to do more—and they are supplying some 6 million tests and scans for patients across England.

On the important issue that my hon. Friend raised, my officials and Levelling Up officials are already considering how primary care infrastructure can be better supported in the planning process to ease the pressure on primary care estates, particularly in areas of housing growth. I know that she will continue to be as conscientious in her campaigning on that as she is on other matters.

Rural communities need local, easily accessible primary care. Since Long Crendon surgery closed during the pandemic, patients in that village and surrounding villages have been displaced, mainly to Brill and Thame, for GP appointments. For the vulnerable and those without private cars, the absence of regular bus services can mean an unaffordable £25 at least in taxis to see a GP. I have raised many times an innovative approach to building a new health centre in Long Crendon by the parish council, which has the land and the agreement by the ICB for the rent to put Unity Health in there—we just need the money to build it. Will my right hon. Friend break down every barrier to help us get that health centre built in Long Crendon?

Again, I very much admire the effort and determination that my hon. Friend is showing to stand up for his constituents. He will know that sadly I am constrained from commenting on individual cases, but what I do know is that the innovation he is showing alongside his parish council—and, indeed, I would hope, his local integrated care board—is the approach we want to adopt across our rural and coastal communities to ensure that they, too, have the access to primary care that we all expect.

Equal access to primary care is so important, but the use of physician associates is downright dangerous. Does the Secretary of State agree that patients have the right to see a qualified GP and not be fobbed off with a two-tier primary care system?

I understand the concerns—we have seen them in the media—but, please, we in this House have a responsibility to our constituents and to professionals working in healthcare, including our clinicians and physician associates. In fact, physician associates have been working in the NHS for some two decades. They are there to work with doctors to assist them, freeing up doctors’ time to focus on the tasks that only they are qualified to do. We have been very careful to listen to the concerns raised, which is why we recently announced intentions to regulate them. But, please, we must all take that responsibility for ensuring that we are not spreading concern. Actually, these roles can have a very positive effect on healthcare system.

My constituents are fed up with battling to see a GP. I have been working hard across party lines with local councillors and the ICB, but I was surprised to hear from the Prime Minister in response to a question last week that only £2 million was allocated to my ICB for primary care, and that it should raid its hospital refurbishment budget instead. Could the Secretary of State advise me which part of the much needed hospital investment should be overlooked to compensate for the failure to invest in primary care locally?

Again, it is for integrated care boards to assess the needs of their area. If there are concerns about access to primary care, we are keen to give them the autonomy to make decisions about how they spend their budget. We have set expectations of integrated care boards in a couple of respects—in particular, we expect them to use the money that we have provided for dental care and we have set clear expectations that integrated care boards will introduce at least one women’s health hub in their area this year.

While we are talking about the recovery of primary care and the Secretary of State is at the Dispatch Box, the recovering access plan released last May talked about high-quality online consultation, text messaging services and online booking tools. They were due in July, but that became August and then December, and I understand that it has now been delayed indefinitely due to a claim made against NHS England in what is a £300 million project. That delay is hitting access to primary care. Will the Secretary of State update the House?

We are determined to bring not just primary care but the whole NHS up to speed with technology. We are firm advocates of the idea that technology can help free clinicians’ time and ensure that they are spending time looking at their patients rather than at computer screens. In primary care, we are working to ensure the digital telephony services that have played such a critical role in providing those 50 million additional appointments, as I described. I will take away my hon. Friend’s points, and look into them carefully.

I have been corresponding with the Primary Care Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), and her predecessors about urgently needing to protect general practice locations in city centres from outdated Treasury rules that potentially force them to move to ring-road locations. The Minister’s latest reply suggested that the ICB could use capital funding to pay for new premises, but my ICB claims that that is against the rules. Would she and her officials please urgently meet me and my local ICB to bottom out what the rules are and urgently protect our city centre GP locations?

The simple fact is that the Conservatives have been in power for 14 years, and general practice has never been in a worse state. Despite slogging their guts out, GPs are struggling because this Government have cut 2,000 GPs since 2015, making it even harder for patients to get an appointment. Given that, why has the Government decided that the NHS needs what the Institute for Fiscal Studies has described as the biggest funding cut since the 1970s?

It has been a very long time since Labour were in government, but even the hon. Gentleman knows that Ministers will never comment on fiscal events the day before they occur. Let me introduce some facts into his analysis. We have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with 363.8 million booked in the last 12 months. That compares with 312 million deliveredin the 12 months to December 2019. [Interruption.] If the hon. Gentleman stopped shouting, perhaps he would be able to hear me. About 62,000 more appointments were delivered per working day last December, excluding covid vaccinations. We have our primary care recovery plan, and it is working. Of course there is more to do, but even the hon. Gentleman would not be so churlish as to deny those extra 50 million appointments.