NHS and Social Care Funding

Huw Merriman Excerpts

Wednesday 11th January 2017 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

We need to look afresh at the entire health and social care pathway, which is why I am delighted to be able to contribute today. From visiting the pharmacist, to attending a GP appointment, to spending time in hospital, whether planned or through A&E, to being able to reside beforehand and afterwards at home or in a care home, we need to find the most efficient and dignified way to treat and look after people. We must avoid using one treatment centre as a default option—that is not the best option either for the individual or for the public purse—because it is the only one available owing to difficulties with individual funding pots, opening hours or lack of access to better forms of provision. We must also be encouraged to speak freely about the pressures in the system and to provide ideas. It has frustrated me for years that anyone who thinks aloud about ideas that could change health and social care for the better is denigrated as seeking to harm it when the opposite is true.

To that end, I listened with interest to the Secretary of State’s interview on Radio 4 on Monday morning. It struck me as measured and thoughtful about new ideas. I was particularly interested in the suggestion about how we could deliver more capacity in the GP system, because an increasing number of people attending A&E are neither accident victims nor in need of emergency treatment; they do, however, need some form of medical intervention, as the Secretary of State mentioned. It was then thoroughly depressing to read the Secretary of State’s words taken out of context. I hope that he will continue to think outside the box and that all Members will recognise the benefits of his so doing.

Speaking of ideas, I have the following suggestions for each of the treatment centres in the health pathway, starting with pharmacies. In the event that we have too many pharmacy clusters, I completely agree with the need to ensure that they are spread out across the country, with the money saved being recycled. At the same time, we should find ways to help pharmacies deliver more interventions to free up capacity at GP surgeries. We must do more to signpost patients to pharmacies before they go to their GP. A recent report costed common ailment treatment in community pharmacies at £29 a patient. The cost rises to £82 for GP practices and to £147 for A&E. Treatment results across all three were equally good. The research estimated that 5% of GP consultations for common ailments could be managed by community pharmacies, equating to more than 18 million GP consultations that could be diverted.

I was buoyed by the Secretary of State’s suggestion that more GPs should be placed in A&E departments and in care homes. The new NHS pilot requiring GPs to undertake weekly ward rounds in care homes is the right type of thinking to prevent emergency treatment in our hospitals. I welcome GP surgeries opening on Sundays, but surely only one surgery in each area needs to be open. I do not believe that having all GP surgeries open seven days a week is a good use of scarce resources, in the same way that Government funding of two pharmacies across the road from each other is not a good use of such resources.

I have long taken the view that we need to find ways to free up our GPs’ time, so that they can focus on the patients who need them most. There are too many wasted or cancelled appointments because the service is free. If there was a cost to unjustifiably failing to keep an appointment, it may demonstrate how precious this resource is—just as NHS dentists would charge for a missed appointment when I was younger.

Some of the reforms of pharmacies and GPs are designed to ensure that patients only attend A&E if they have had an accident or in an emergency, which is clearly not the case for some who are now attending. We are also facing demand for hospital places because of a need to reform the way we look after an ageing population.

Time does not allow me to talk about social care, which is so important in my constituency, but the Government’s delivery of more social care funding before Christmas is welcome. However, it is crucial that we question the operating model in social care. The NHS benefits from a national funding programme, but social care is largely the responsibility of local authorities and local rate payers in areas where retirement rates may be high but employment and council tax receipts are not. We have to think radically to ensure that we get the best out of our health and social care system. To do so will not only make resources stretch further but will deliver innovation that improves the lives of the sick and infirm, who are most in need of our care.