GP Funding: South-west England

Jess Brown-Fuller Excerpts

Wednesday 25th June 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to serve under your chairmanship, Dame Siobhain. I thank my hon. Friend the Member for Newton Abbot (Martin Wrigley) for securing today’s important and timely debate. He is a tireless advocate for his local community, and I commend him for shining a spotlight on GP funding and the broader state of healthcare in the south-west. He spoke about the funding model for GPs, which is complex, obscure and outdated, and does not account for rurality.

As the Liberal Democrat spokesperson for hospitals and primary care, I hear all too often from my constituents and from people across the country who are struggling to access the care they need. Our NHS is the pride of the nation, but years of underfunding and mismanagement under the last Conservative Government have left services in crisis.

Nowhere is that more apparent than in general practice, with patients facing increasingly long waits to see a GP, as highlighted by my hon. Friend’s statistics. In 2019, the average GP had 1,900 patients on their books; today, they have 2,400, and some people cannot get an appointment at all. People rightly tell me that they are not included in the Government’s waiting list statistics because they have not managed to get on a waiting list in the first place—or even speak to a doctor.

Those are not isolated complaints. I am sure many hon. Members will recognise those concerns from their own constituency surgeries, or from spending a morning with their local GP, as my hon. Friend the Member for Mid Dorset and North Poole (Vikki Slade) described. We also need to be honest about the scale of the problem. In 2024 alone, more than 2 million people in the south-west waited over 28 days for a GP appointment, and that pattern is repeated across the country. Chichester is not in the south-west, but nearly 30% of patients in my constituency had to wait more than two weeks, and around 8% waited more than a month. That is not acceptable.

The hon. Member for St Austell and Newquay (Noah Law) made an important point about tourism. The population of my coastal communities such as Selsey, Pagham and the Witterings doubles over the summer months with holidaymakers, which can put additional stress on primary care services.

My hon. Friend the Member for South Cotswolds (Dr Savage) made an important point about the role that planning and ICBs play. Too often, developers come forward with large site proposals that include a GP surgery on the site. However, unless they have buy-in from the ICB, so often those GP surgeries that have been specifically designed for that purpose sit empty without a GP practice to go into them.

My hon. Friend also spoke about her village of Sherston. It might not be the centre of my universe—that is my little rural village of Westbourne—but both Sherston and Westbourne face the exact same problems. My village of Westbourne is about to lose its rural surgery; we are waiting for the ICB’s final decision. Residents of Westbourne do not have a public transport link to the GP that they are being asked to go to, across the border in Emsworth.

The Liberal Democrats believe that everyone should have the ability to live a healthy and fulfilling life, which means they must have timely and local access to healthcare, whether that is from a GP, a dentist, a pharmacist or a mental health professional. We must invest in early access to community care, in order to relieve the burden on hospitals and fix the social care crisis that leaves too many people stuck in hospital beds waiting for help that never comes.

Research by the House of Commons Library that was commissioned by the Liberal Democrats found that funding for GP practices was cut by £350 million in real terms between 2019 and 2024. Those cuts have hit communities hard, and the impact is being felt not only by patients but by the hard-working professionals trying to keep the system going. GPs who I speak to are burnt out and overburdened, and GPs in general are leaving the profession in record numbers. The result is a vicious cycle, with fewer staff, longer waits and growing public frustration. I know some incredible GPs, and New Zealand is really lucky to have them, but I would rather they were here. Despite a 2019 Conservative pledge to hire 6,000 more GPs, by the general election last year there were 500 fewer GPs than when that pledge was made. In fact, the UK has 16% fewer qualified GPs per capita than comparable high-income countries.

It does not have to be that way. Healthcare is not a luxury. It is a fundamental right and not a privilege. Everyone should be able to see a GP when they need to, and that is why the Liberal Democrats are calling for a legal right to see a GP within seven days, or within 24 hours if the situation is urgent. To make this a reality, we are calling for the recruitment of 8,000 more GPs. We would achieve that by supporting junior doctors to specialise in general practice and by introducing new schemes to help experienced GPs to return to the workforce.

As my hon. Friend the Member for Yeovil (Adam Dance) said, we also believe that everyone over 70 and those with long-term conditions should have access to a named GP. Such continuity of care is not only vital for building trust and supporting staff morale; it also improves health outcomes and saves money in the long term. As my hon. Friend the Member for Oxford West and Abingdon (Layla Moran), who is the Chair of the Health and Social Care Committee, has said, continuity of care is key. Patients who have had the same GP for more than 15 years have a 25% lower chance of dying compared with patients who change GPs regularly. Continuity of care builds trust, improves outcomes and reduces hospital admissions. It is good for patients, good for staff and good for the system as a whole.

We must also address the broader picture. Community pharmacies are closing at an alarming rate when they should be playing a bigger role in delivering frontline care. Fairer and more sustainable funding is needed to keep these services open, to relieve pressure on GPs. I am a big fan of Pharmacy First and I know that the Minister is, too; I have heard him talk about his passion for it. But pharmacists in my constituency tell me that with the regular increase in targets, they are struggling to keep up.

[Adam Dance]

I spent an evening with one of my local pharmacists, and it was so shocking that people were coming 20 or 30 miles to his pharmacy, because it was the only one open near my village of South Petherton. He was struggling so much because he could not get the medication that people needed, despite the fact that they were travelling so far to try and get medication from him. Does my hon. Friend agree that that is just not good enough and that the Government need to support pharmacies a lot more?

[Jess Brown-Fuller]

I am sure the Minister will talk about the hub and spoke model that the Government are championing, but my hon. Friend is right about the difficulties in rural areas especially. Many constituents have talked to me about the distance they are having to travel to get basic medication that means they can function, go to work the next day or get their children to school.

This is why we have been calling for a fairer and more sustainable long-term funding model for community pharmacies. They play a vital role in relieving pressure on GPs, yet they are being squeezed out of existence. Since 2017, 1,200 pharmacies have shut their doors. Community Pharmacy England has warned of real-terms funding cuts of at least 25% since 2015, leaving the network on the brink of collapse.

This is not just a failing system; it is a broken one. This Labour Government have a responsibility to act. They were elected on a promise of change, but that change must begin with fixing our NHS. I am sure the Minister will celebrate the budget increase, but as my hon. Friend the Member for Melksham and Devizes (Brian Mathew) said, this has been swallowed by the increased costs and national insurance contributions. That is why the Liberal Democrats tabled an amendment to exempt healthcare services from the NICs rise, which the Government chose not to accept.

General practice is the front door to our health system. If we do not invest properly in GP services, everything else suffers. We must not let that door remain closed to so many. As my hon. Friend the Member for Newton Abbot rightly said, we do not have to accept broken systems—we can fix them, and now is the time to prove that we will. Will the Minister commit to the Liberal Democrat proposal of a legal right for patients to see a GP within seven days, or within 24 hours in urgent cases? Does he agree that everyone over 70 and those with long-term health conditions should have access to a named GP?

--- Later in debate ---

[Jess Brown-Fuller]

It is interesting that the Minister mentioned devolution, because the effect of the cuts to ICBs has meant that Sussex ICB is now having conversations with Surrey ICB about a merger. The cuts are therefore achieving the exact opposite of devolution, because such a merger would move power further away from communities. Does he have any thoughts on that?

[Stephen Kinnock]

Integrated care boards in the south-west have received almost £1.3 billion in their primary medical care allocation for ’25-26, which is an increase of nearly 13% compared with ’24-25, so I am not quite sure where the hon. Lady is getting her figures. For me, a 13% increase is not a cut.

That growth in local resources includes the south-west’s share of the additional £889 million agreed for the GP contract, as well as the transfer of some additional roles reimbursement scheme funding that had previously been held centrally by NHS England. Those funding allocations will be further uplifted to fund in full the pay recommendations of the DDRB and the NHS Pay Review Body.