Health Services: Wantage and Didcot
(1 year ago)
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David Johnston (Wantage) (Con)
I campaign a lot in this House on behalf of young people, having had a career working with them before I got here. I campaign a lot on the environment, which is important to me and to many of my constituents. But the biggest thing I campaign on in this place is infrastructure, because we do not have the infrastructure for the number of houses and the population in the constituency.
I campaign for the reopening of Grove station, which my constituents have wanted for over 50 years. I campaign for better broadband in certain parts of the constituency. I campaign about our roads, because most visitors and most residents, like me, feel that the roads in Oxfordshire are more pothole filled than almost anywhere else we go in the country. We have two important roads in my constituency, the A420 and the A34, both of which have significant safety concerns. Indeed, the last time I had a debate of this kind, it was on the A420 and A34. But the No. 1 infrastructure issue in my constituency is access to health services—in particular, GPs and dentists.
For six weeks or so, I conducted a survey of my constituents, asking them to tell me about their experience of accessing health services. I am grateful to the nearly 3,000 people who completed the survey. More than three quarters of them said that they had found it difficult to get a GP appointment in the past 12 months, which is significantly more than the number who said they had found it difficult to get a dentist appointment, although that figure was also far too high at 44%—the issues for dentistry are slightly different. Only one in 10 people who completed the survey said that they had had no trouble accessing health services, and 5% had not tried to access health services in the past 12 months and so were not able to say whether it had been difficult. Overwhelmingly, I heard over and again that we need more GP surgeries and more dental surgeries. People would like to see other services, such as more mental health provision and more physiotherapy provision, but GPs and dentists had by far the biggest responses.
The situation is most acute in Didcot, where I live. Huge numbers of people have come to live in Didcot in recent years. The Great Western Park estate, with 3,500 homes, was promised a GP surgery, and it is still waiting eight years later, with absolutely no progress having been made. Meanwhile, the new Valley Park development on the border of Didcot will have 4,200 homes, so it will add a lot of pressure. Those two estates alone will add about 18,000 people to the area’s population, which is more than enough to fill a GP surgery, yet we continue to see no progress. After encouraging people not to use NHS services if they could avoid it during covid, we now have a backlog to address, but there was an issue long before covid, too. Infrastructure has not kept pace with population growth.
The politics is that the Liberal Democrats are running every part of local government, including both district councils in the seat I represent, and they run the county council in coalition with the Greens and Labour. Of course, the Liberal Democrats say that this is all the Government’s fault, but they have been in charge of one district council since 2019, and they have been in charge of the other in coalition with the Greens since 2019, so it is not good enough to say it is all the Government’s fault. We have to get to a better system of accountability for both local council leaders and local health leaders.
It is partly about the Government training more doctors, and I very much welcome all the things the Government are continuing to do in this area. We are training 2,200 more doctors than in 2019, and last year a further 4,000-plus took up training places to become doctors. The increase in appointments is welcome, with 2 million more appointments in March 2023 than in March 2022, and there is investment to get 15 million more appointments by 2024.
The recent announcement on tackling the 8 am rush chimes with my inbox. My constituents are constantly writing to explain to me how frustrating it is to ring at 8 am, as they are advised, and not get through. The record goes to the person who told me they had called 117 times, and others have called 89 times. The numbers are huge, with people ringing over and again, getting very frustrated and eventually contacting me to say they do not know what to do. It does not matter how often they ring, because they are not able to get through.
I welcome the fact that the Government are now saying that people who ring will be referred to an appropriate service, such as 111 or a pharmacy, without needing to call back. I also welcome the increased role for pharmacists, because it right that they ought to be able to give out the oral contraceptive pill and medicines for sore throats, earaches and such things. They are well equipped to do that and it will ease some of the pressure on the GP surgeries.
The situation we find ourselves in is not the fault of the existing GP surgeries. Indeed, I asked them to promote my survey and many of them did so, because they are feeling the pressure. Several surgeries have closed their books temporarily because they were simply unable to take on many more patients. Of course, that affects everybody’s quality of life, because people who have lived in the area for a while and used to find it easy to get an appointment no longer can, and people who have moved to a new area and hope to be able to register with a doctor find that they are unable to do so. This is one of the most important services we could be providing for people.
The Minister knows that because I am the Parliamentary Private Secretary to the Secretary of State for Levelling Up, Housing and Communities, I am going to swerve housing and planning policy, as I should not be talking about it in that role—I know the rules. However, we do need a couple of things, one of which is a much better accountability mechanism for local councils and local health leaders to plan for population increases and then deliver services as the population increases. The Government can and will train more doctors, but we are making promises to local people about what is going to come with increased numbers of people, and those promises never arrive. People then stop believing in the promises, and those who were not opposed to new houses, because they realise that people need somewhere to live and perhaps their children and grandchildren are struggling to get on the ladder, become resistant to more housing as they have seen so much housing arrive without the services that should go with it.
Let me move on to the other thing that is important to me. It may feel like a side issue, but it is fundamental. In my pre-politics career, I ran charities for disadvantaged young people and promoted social mobility. The medical profession is the most socially exclusive profession in the country—only 6% of doctors come from a working-class background, and someone is 24 times more likely to become a doctor if they have a parent who is a doctor—and it has been that way for some time. To an outsider, the situation seems to get worse. Recently, the British Medical Association’s junior doctors passed a motion to cease apprenticeships into medicine, which are supposed to widen access to it. Almost every other profession has some form of apprenticeship to try to widen access, but the BMA’s junior doctors have passed a motion saying, “We don’t want them.” Given the state of the profession, which in no way reflects the country’s talent, for all sorts of reasons—I used to work on this, so I know that it is about access to work experience, recruitment methods and so on—that is a very retrograde step. That is certainly the case when this is the most socially exclusive profession in the country. We have a shortage of doctors in particular areas, and this is profession where the ratio is at least 10 applicants to one medical school place. I worked with so many disadvantaged young people for whom this was their dream career—it was the most popular career at one charity I ran—so it seems mad that we are not making better use of that talent. I feel sure that it could help ease some of the pressure we are seeing, not just in my constituency, but in others.
In closing, I say to the Minister that I very much want to meet him to discuss how I can bang heads together and make progress to get things delivered. It is a shame that it is not within an MP’s control to be able to deliver new GP surgeries and so on, but I want to work with him to work out how we can do that and possibly have a health hub in my constituency. This is not the first time I have talked about this matter—I have done so more than 20 times—and it will not be the last; I will do so until my constituents get the health services they deserve.
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
I congratulate my hon. Friend the Member for Wantage (David Johnston) on securing this important debate. He mentioned in his remarks that there are limits on what he is allowed to say in this Chamber about certain aspects, particularly about how we marry up new housing with new GP surgeries, but none of us in Government are in any way strangers to his very strong views on the subject. The amount of work and campaigning that he has done on this issue is formidable, and I pay tribute to him for that.
I recognise the struggles that my hon. Friend’s constituents have reported in his survey in getting an appointment with their GP or dentist. Despite the efforts of general practice teams, who are now delivering something in the order of 10% more appointments every month than they were pre-pandemic—that is the equivalent of about 20 more appointments per working day, per surgery—demand is rising. We have about 30% more people over the age of 70 than we did in 2010. Those people tend to have about five times more appointments than younger people. Therefore, because of the ageing society and the effects of the pandemic, demand is rising. That is why we have listened and why we have taken action, including just last week publishing our primary care recovery plan to address some of these concerns.
Our plan is ambitious and it will modernise access to general practice—effectively the front door of our NHS. We want to end the 8 am rush for appointments and ensure that patients know how their requests will be handled the first time they contact their practice. To achieve that, we are investing the equivalent of £6,000 per practice to provide new technology, including modern digital phone systems so that people do not get engaged tones, and easier digital access so that many more issues can be dealt with online at a convenient time for the patient, which will free up phone lines for those who do need to call so that they always get through easily.
As my hon. Friend mentioned, we are expanding the role of community pharmacies in delivering primary care and investing up to £645 million to enable pharmacists to provide treatment for common conditions. Pharmacists will be able to supply prescription-only medicines and start courses of oral contraception for the first time. That will provide more choice for patients and be a convenient way of getting treated. It will also reduce the pressure on general practices, freeing up something in the order of 10 million appointments a year, again making it easier for my hon. Friend’s constituents to get through. We have started consulting the Pharmaceutical Services Negotiating Committee, with a view to introducing the new service by the end of the year.
We are continuing to cut bureaucracy to reduce the time that GPs have to spend on work that is not work that they need to be doing. The plan frees up approximately £37,000 per practice by cutting back targets and improving communication between GPs and hospitals—something that has been raised with me many times by GPs. Of course, we still need to deliver more appointments and, to do that, we need more staff. I am pleased to say that today, we have managed to deliver, ahead of schedule, our manifesto commitment to recruit 26,000 additional staff into general practice. Those extra staff are helping to deliver the 50 million extra appointments that we promised by March 2024. It is through both the additional staff that we have invested in and the very hard work of general practice teams, to whom I pay tribute, that they are already delivering 10% more appointments compared with 2019.
The recruitment and retention of general practitioners remains a big priority for us, including the retention of our wonderful experienced general practitioners. That is why we are helping to retain senior GPs by reforming pension rules—the No. 1 thing that the profession was asking us for—and lifting about 8,900 GPs out of annual tax charges.
My hon. Friend quite rightly raised some specific concerns about the provision of adequate services to meet the needs of new housing developments—something that is an issue in particularly desirable and fast-growing areas like that of my hon. Friend. I am very seized of this crucial issue, and we are working on it in real time.
Last week we announced that, as part of the GP plan, we would be making a series of reforms through the national planning policy framework and planning guidance changes to ensure that new housing always comes with the GP surgeries that are needed. That means changing the NPPF and planning guidance and, even before that, updating the planning obligations guidance to ensure that local planning authorities address primary care infrastructure, just as they do other infra- structure demands such as education.
On top of that, the Government will update guidance to encourage local planning authorities to engage with the local NHS—the local integrated care boards—on large sites that might create the need for extra primary care capacity. My hope is that a bigger chunk of the £7 billion a year that we are raising from housing developers will flow into new primary care facilities.
As my hon. Friend mentioned, local authorities have an unavoidable and crucial role in enforcing the delivery of the commitments that developers make and in ensuring, as they make and enforce their local plans, that what was promised is delivered. Wherever new development is planned, they must plan for the infrastructure that is needed alongside it. That is something local authorities absolutely must deliver for their constituents, and I am sorry to hear that there seems to be some trouble with that in his constituency.
My hon. Friend also mentioned challenges with dentistry; we are working on that very actively and will be publishing our plan for dentistry shortly. The reforms we made some months ago to enable dentists to do more—about 110% of their contracted work—and to split up the bands so that they are paid more fairly for the NHS work they do have been received well by the profession. About a fifth more people were seen by NHS dentists in the year to March compared with a year earlier, so we are starting to make progress, but we know there is more to do. To answer his question, I want to reassure him that we will be publishing our dentistry plan very shortly.
I thank my hon. Friend not just for his thoughtful speech today, but for all the work he has done to campaign on this issue ever since he was elected. He always makes a powerful case, both in the Chamber and behind the scenes, and he has many thoughtful ideas that are already influencing Government policy. I pay tribute to him for his work and I hope his constituents will soon see positive changes as part of our recovery plan.
Question put and agreed to.