GP Funding: South-west England

Vikki Slade Excerpts

Wednesday 25th June 2025 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairship, Dame Siobhain.

GPs epitomise the NHS for us all. They support us from cradle to grave like no other part of the NHS. Although they represent 90% of the patient’s experience of the NHS, they get less than 10% of the budget. To better understand these issues, I have spent recent months meeting doctors and practice managers, but I have also spent a morning shadowing a GP at Walford Mill medical centre in Wimborne to see the reality of their life at first hand.

I thank Dr Wright and every patient who kindly allowed me to observe often deeply personal and distressing consultations. I witnessed high-quality, compassionate care. Despite a busy schedule, the GP took time to liaise with hospitals, arrange tests, write referrals and fully support his patients. Almost every patient was supported with more than they arrived to discuss. He sensitively raised worrying comorbidities with them and encouraged them to come back and think about their wider life. I could not fault the care that he gave.

That brings me to appointment times. The British Medical Association recommends 15-minute appointments for GPs. Most surgeries allow only 10 minutes, but they typically try to get away with five minutes. There is no way a GP can look after a person in that time, particularly given the emotional connection that they have with their patients. One minute they are telling a patient that they have cancer; the next, they are comforting a new mum who is worried about the health of her baby. How does a doctor download their own emotions in between, particularly when they are dealing with financial pressures and their own home lives too?

GP surgeries are also struggling with having to do things that they were not designed to do and not being reimbursed properly. One of the issues I witnessed was the reimbursement of blood tests. That practice recently negotiated a contract with NHS Dorset, which not only did not agree with the amount that the GP said they needed, but cut it dramatically. The GPs are being reimbursed at 25% of the actual cost to them, so they personally subsidise every blood test that they undertake, in a drive to push blood tests to hospitals where patients do not want to be and that they cannot get to. It is quite distressing for them. It is in the patients’ best interests for blood tests to be taken locally.

On the flipside, NHS Dorset’s pathway for cancer means that the follow-up investigations, including some very personal examinations, have to take place at a surgery with a GP who does not know the patient. The patient does not start their cancer journey by going to the hospital and seeing people who actually know about cancer. I found that quite worrying and distressing.

The other issue I experienced was the discrepancy between the electronic systems used by GPs and the paper systems used by doctors in hospitals, where letters were still being sent by post, causing delays and additional administration in surgeries. Bizarrely, paper prescriptions were still being issued by hospitals, meaning that patients were not able to leave to get their prescription elsewhere, and people rushing to get their family member home were having to get a new prescription, creating more delay and unnecessary work for GPs.

I have some examples with which the Government can perhaps help. I am grateful to the Minister for replying to one of these cases, so it may be familiar to him. The GPs at Wareham surgery are all partners, and they are working out of a building that was part of a hospital and ambulance station, but the building is falling down. The hospital was going to be rebuilt, but that was shelved long ago, and the surgery has finally found a new building. Unfortunately, the building comes with a 25-year lease, which extends beyond even the most youthful of partners, and there is no break clause. It also has a requirement that there be at least three GP partners, and if there are not, retiring GPs will remain personally liable until there are.

However, what we are finding in both Wimborne and Wareham is that people can no longer afford to be a partner in these surgeries. Bethan, my niece, is a GP in her early 30s, and she has probably accrued more than £100,000-worth of debt to get there. She probably has a £250,000 mortgage, because she lives on the south coast. How on earth can she, as a young woman, be expected to take unlimited personal liability on top of that? More people are therefore becoming salaried GPs. They are working their socks off in clinical terms, but they do not have any of the burden of running their surgery, taking that responsibility and subsidising patients.

The GP surgeries I mentioned are struggling to find people willing to be a partner, so that they can take up that lease. I did not hear from the Minister any real reassurance or understanding of the fact that the nature of being a GP is changing. What are the Government doing? Are we expecting the GP partner model to be phased out, and if so, what will replace it? How do we make sure that these organisations can remain?

I was most bothered when the chief executive of NHS Dorset said that GPs are independent contractors and are responsible for sorting out their own businesses. I find it absolutely appalling that we treat our GPs as if they are the local carpenter. GPs are the heart of our communities, and we need to start talking about them as an integral part of the NHS, not as an independent business that needs to make money. These people are not making money; they are saving our lives and keeping us well, and we need to treat them much better.

The population of Wimborne has doubled, and people are worried because the town has lost a GP surgery. They are constantly writing, “We need another surgery.” The surgery in Wimborne, like most surgeries, wants to expand, but one of the problems with the funding model that GPs can access—I would be grateful if this could be looked at—is the requirement to bid, design, obtain planning permission and build within a financial year. With the best will in the world and the most efficient planning system, there may be a tiny district that can do that, but I do not know anywhere that can complete the whole process in a year. We need to find a way for GP surgeries to access funding over multiple years, so that communities know they have an NHS fit for the future.

I look forward to the Minister’s comments.

--- Later in debate ---

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

It is a pleasure to serve under your leadership, Dame Siobhain, and to be here. I pay tribute to the hon. Member for Newton Abbot (Martin Wrigley) for securing this debate on a topic that I am all too familiar with, having spent time as a GP. This place may not be so familiar with the inner workings of GP practices, so it is fantastic to have the chance to discuss it. I declare an interest: many of my immediate and wider family are GPs, and it is important to put that on the record.

This debate has allowed us to discuss a huge variety of things, including the Carr-Hill formula and the QOF. We did not touch on DES and LES—directed enhanced services and local enhanced services. Rural dispensing practices are a really important funding stream. We have talked about the partnership model, retention, joining up services, ICBs and their toolkits, the interaction with the planning department and rurality, which has a particular impact on services in my area.

I want to pick up on the comments made by the hon. Member for Mid Dorset and North Poole (Vikki Slade). Fair play to her for going out and shadowing a GP to see what their life is all about. At the heart of what she said was the good care that goes on. If we were to believe the Daily Mail, every GP is on the golf course and only cares about the money. The money is important, but GPs care far more about the patients and the quality of care they give. That is what drives them and gets them out of bed each day. We in this house must not forget that when we discuss healthcare, because it is important. We will get far better healthcare than ever before in the last few decades, and we must not lose sight of that.

I am grateful to the hon. Member for Newton Abbot for giving me my first chance as a shadow Health Minister to debate general practice and ask the Minister some questions. Without further ado, I will turn to those questions. First, what is the Government’s current position on primary care and its models? In an interview in The Times in January 2023, the current Secretary of State for Health and Social Care said:

“I’m minded to phase out the whole system of GP partners altogether and look at salaried GPs working in modern practices alongside a range of other professionals.”

He went on to speak at events held by the King’s Fund and the Institute for Public Policy Research, where he acknowledged that he has

“observed a GP partnership model in decline where very soon we’re going to have more salaried GPs than partner GPs”

and that the

“status quo is not an option”.

Then 18 months ago, just six months before the election, the Secretary of State stated,

“What we were minded to do is to sort of phase it out over time. I’m still not sure whether or not the GP partnership can survive in the longer term. But I haven’t reached a sort of firm conclusion that says that it shouldn’t.”

In the light of that, and given the importance of the partnership model, could the Government clarify their position with regard to the partnership model and any other models that are being considered?

[Vikki Slade]

I thank the hon. Member for his comments about my visit to the GP, because it was an absolutely wonderful experience. If the proposal is to phase out the partnership model and move to a salaried model, how would that work, given the severe cuts that ICBs are facing? With 50% cuts to most of the ICB funding, somebody will have to pick up the costs of running these organisations, rather than the clinical side of it.

[Dr Evans]

The hon. Lady is spot on. I posed my question to the Government because we know that primary care is one of the most efficient parts of the NHS. Why? Because the people running those businesses—they are businesses, and we have to be open and honest about that—pay attention to where the money comes in and goes out. They take full pride in it, first, because they care, and secondly, because their salaries are paid from the profit that comes out of that. Again, “profit” is a dirty word that people do not like to use, but it is the reality of what we are dealing with when it comes to how we break down the funding.

The Government have proposed to get rid of NHS England, and it is still unclear not only how much that will cost, but how much it will save and where the administrative burden will fall. On top of that, we do not know what will replace the partnership model if we lose it, and this is the question to be asked. Given that it was only six months before the election that the Secretary of State stated his intent, I too am keen to find out the answer.

I have a second question to pose to the Government. There are concerning reports this month in the Health Service Journal, which has had sight of a leaked version of the Government’s 10-year plan to improve the NHS. It says that the plan will push back the Government’s ambition to increase the share of NHS spending on primary and community care to 2035, rather than 2029 as originally promised. Can the Minister confirm or deny those reports?

When it comes to funding, the Government raised taxes directly on GPs as part of the national insurance increase. Has the Department made any assessment of how much of the £886 million uplift that has been allocated to GP practices will be needed to meet the increase in employer’s national insurance contributions?

I turn to the figures for the ARR scheme. The Government announced in April that they thought they had reached 1,500 new GPs, but as the RCGP pointed out at the time, although having

“more GPs employed in the workforce is encouraging, when considering full time equivalent GPs—which gives the most accurate picture of the GP workforce and the care and services GPs are able to deliver for patients—the numbers published today are lower, at 851 GPs”.

The increase is encouraging, but when we dig into the data, it appears that we are simply seeing more locum doctors coming back into the scheme. I would be grateful to understand exactly how the numbers are made up, and where the inference of 1,500 GPs comes from.

More importantly, where is the scheme going in the future? Is it time-limited? Will it continue? Will it be expanded and, if so, what does that look like? Although it is an important part of addressing provision, we also need to understand exactly what is going on. Initial reviews of the data suggest that appointments have not kept up with the pace of the introduction of GPs, so I am interested to understand from the Minister why, despite the supposedly new GPs coming in, the number of appointments has not increased proportionately. I would be grateful for any comment on that.

Finally, I turn to recruitment. Training new GPs has understandably been seen as the priority when it comes to solving the long-term workforce problems in England. As Pulse magazine puts it:

“This is probably one of the areas of workforce planning that could be considered a success. Health Education England, which has been incorporated into NHS England, has been able to meet its target of over 4,000 new GP trainees a year.”

The NHS workforce report, launched under the previous Government in 2023, made commitments to increase that. It set goals to increase the number of GP specialist training places to 6,000 by 2031, ensure that all foundation-year doctors do a rotation in general practice, and require GP registrars to spend the full three years in general practice.

There has been progress, but along with progress come new problems. The British Medical Association has warned that up to 1,000 GP registrars could face difficulty when qualifying in summer 2025 without funding for GP practices to recruit newly qualified, unemployed or underemployed GPs. What active steps are the Government taking to avoid that, and what support will they be offering newly qualified GPs?

--- Later in debate ---

[Stephen Kinnock]

We recognise that the partnership model has many strengths. It is a very important part of the system, and it helps to drive efficiency, innovation and a kind of go-getting approach to general practice. That is what we want to see—innovative approaches.

We are committed to substantive GP contract reform. We see the partnership model as a really important part of that, but we also recognise that fewer GPs are interested in going into partnership. The partnership model is not the only model delivering general practice; GP practices can and do choose to organise themselves in different ways. Many practices cite evidence of good outcomes on staff engagement and patient experience through the partnership model. I do not think it is right to say that there are any specific plans to change the partnership model, but we recognise that there are a number of other ways, and we will always keep the way in which the contract is delivered under review.

[Vikki Slade]

For some leasehold properties, there is a requirement that practices have partners. How is the Minister ensuring that such practices can be taken on, either by the ICB or the DHSC? Somebody has to take responsibility for those practices, and if we are moving to a model of having more salaried people, who will do that?

[Stephen Kinnock]

In debates about how we deliver health and care in our country, the question often comes up about the balance between the role of the DHSC at the centre, the role of ICBs and the role of those who are at the coalface delivering services. I do not think there is a single answer to that question. What is important is that we commit to devolution and to empowering those who are closest to their communities, because they are in the best position to make the decisions that work for their communities.

It is vital that we at the centre agree on and set desired outcomes for health, access and quality that the entire system is expected to meet. We have to set a framework, and it is then up to those at the coalface to decide how best to deliver it. It would not be right for me to say, on specific leasehold cases for example, that case A should go this way and case B should go that way; to try to dictate that from the centre would be a recipe for disaster. We do need to hold the system to account, however, and the system needs to hold us to account. That is the way to deliver true political and strategic leadership.

Dementia Care

Vikki Slade Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Dementia is such a cruel disease. Let us be clear that it is not simply part of getting old, yet too often it is treated as though it is inevitable. In my constituency the number of people living with dementia is nearly 40% higher than the national average. One in every 45 adults of all ages has been diagnosed, and we know that the true number is even higher when we include those not diagnosed.

Family members, who provide such amazing care, are relying so heavily on community groups such as Stepping Stones—led by my predecessor and good friend, Dame Annette Brooke—with jigsaws and its tea dances providing moments of joy. The Leonardo Trust provides grants for unpaid carers, and I thank the Museum of East Dorset for its fantastic work in recruiting residents to crochet the over 8,000 forget-me-nots that decorated the town of Wimborne last month.

Neurological conditions such as dementia are the leading cause of illness globally, and as our population ages, the challenge will only grow. However, dementia is not just a disease of old age—some of the most heartbreaking cases are among younger people. A neighbour of mine in Broadstone—a proud veteran, builder and father—was diagnosed in his early 50s. I watched him go from walking past our house without recognising us, to needing a carer by his side and now living full-time in a care home. His daughters, who once played with mine, will never have their father walk them down the aisle and his wife will never share the retirement they dreamed of.

That is why I did not hesitate to become a dementia research champion. If we do not understand how the brain works and how to stop it failing, we will not get the benefits of extended life expectancy. Today, the Daily Mirror has reported that over 100 new drugs are in development to halt dementia, with scientists saying we are at the start of a journey to a cure. Of these drugs, 86% could halt or reverse the disease. However, research alone is not enough, and we must transform the care we give.

Like those of other Members, my constituents are facing a battle just to get the care they need. Andrew was told that his wife Tricia did not qualify for NHS continuing healthcare because it did not meet the NHS-funded nursing criteria of being short term or of optimum potential, despite changing on a daily basis. The council eventually stepped in, but not until Andrew himself had become ill. Why is nursing care not being picked up by the NHS? Surely that is what it is for.

Another constituent, Emma-Jane, told me about her mother, who has dementia and paranoia, and has become abusive. Her father, who had protected his family for so long, once spent the night in a park just to escape. A social worker decided that her mother could not go into a care home, because her mother had wanted to stay at home, despite acknowledging that she lacked the capacity to make such a decision. After accessing respite care when the family reached crisis, Emma-Jane is now funding care privately, while she battles the council because her father simply cannot cope. This is intolerable: families are breaking and councils are overwhelmed.

Kevin wrote to me about his Aunt Jean, now 92, who entered a care home eight years ago. The family home has gone and the money has gone, so the council must step in, but the care home fees are nearly double the local authority cap. Even with Jean’s pension and a discount from the care company, there is a £300 a week shortfall, leaving the family to choose between paying out of their own pocket or moving her from the place she has called home for nearly a decade. To put that into perspective, the cost of caring for Jean for one year, after her pension contribution, is equivalent to the total annual council tax of 24 households. If every dementia patient in my constituency needed council tax funded care, it would consume the council tax of 43,000 homes, and I have only 44,000 in the whole constituency.

We must act: we must invest in research, support carers, and reform how we fund and deliver care. I call on the Minister to push for faster progress on the Casey report. There is no choice: the cost of inaction is too high for our families, our communities and our country.

Parkinson’s Disease

Vikki Slade Excerpts

Wednesday 21st May 2025 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Stuart. I thank the hon. Member for Colne Valley (Paul Davies) for securing the debate. It is interesting that three of the five Back Benchers who have spoken in it are from Dorset. I do not know what that says about our population, but there we go.

[Edward Morello]

I will answer that with one of my favourite facts about Dorset: if we were a country, we would be the oldest in the world by population age. We are older than Japan.

[Vikki Slade]

My hon. Friend and constituency neighbour is correct. We have the Jurassic coast, but we are also the oldest county.

My daughter is currently undertaking a PhD in the causes of Parkinson’s, and I should also declare that I am a member of the all-party parliamentary group on Parkinson’s. Although life expectancy for those living with Parkinson’s is much improved, their quality of life is deeply impacted. They are incredibly vulnerable to falls and infections, limiting their ability to work. The recent changes to PIP are causing deep distress to the community. I look forward to hearing how the Government will recognise the needs of those with fluctuating neurological conditions in assessments.

However, I want to focus on the issues of treatment and care for patients. There are 216 people currently registered as living with Parkinson’s in my constituency. I have been told that there is virtually no service of specialist nurses or active phone line support in my community. That leaves vulnerable people isolated and at higher risk of traumatic, expensive and often unnecessary hospital admissions.

The Minister will be aware that an absolute diagnosis of Parkinson’s is possible only post-mortem—I pay tribute to the work of the brain bank at Imperial and that of the similar motor neurone disease brain bank at King’s College London. We therefore rely on specialists to focus on the symptoms in order to make a diagnosis, but there is a significant problem, which was explained to me this week by a GP at Walford Mill surgery in Wimborne when I spent the morning shadowing him. He told me that wait times for diagnosis for Parkinson’s can be more than six months, so experienced GPs who are able to prescribe medications have a dilemma. They can help their patients by prescribing medications to reduce the symptoms, but in doing so they make it more difficult for the specialists to diagnose the condition. If the referral-to-treatment times were dramatically improved, GPs could ask people to wait, but with the current delays, it seems cruel to ask both those living with symptoms and their family doctor to do that.

That takes me to my next point: the lack of neurologists. The UK is 44th out of 45 countries in Europe for number of neurologists per head of population, and the waiting list for neurological conditions stands at a staggering 232,994 people. According to Alzheimer’s Research, neurological conditions are the leading cause of global ill health, with 3.4 billion people suffering from one, which makes it seem even crazier that we have this problem. It is not only that: Parkinson’s, along with other neuro conditions such as functional neurological disorder and achalasia, which I have raised previously, require multidisciplinary teams to look after patients, and local NHS systems just are not set up to do that properly. Will the Minister ensure that the NHS 10-year plan will deliver ways of working that will support those with such conditions?

Finally, I will touch on prescription charges. I know the issue has been raised before, but the list of conditions for free medication has not changed since 1968. It is shocking that Parkinson’s is not one of those conditions. My constituent, Carole, who was diagnosed aged just 46, is finding that really tough and believes, as I do, that a full review of these conditions for working-age people should be undertaken now.

The final word must go to two of my constituents. Malcolm, from Wimborne, said:

“I have suffered from Parkinson’s for 10 years. It has changed my life completely for the worse. I cannot speak, I have frequent falls, we need better support.”

Danielle, also from Wimborne, who was diagnosed at 38, said:

“This is becoming more common with younger people…The impact of this disease on my life is immeasurable. It is more than a struggle. It is a fight every day. We need these issues addressed urgently to reduce the burden.”

I hope that the Minister will be able to offer us some comfort.

Oral Answers to Questions

Vikki Slade Excerpts

Tuesday 6th May 2025 Commons Chamber

[Karin Smyth]

I am pleased to congratulate the pharmacies that are on the frontline on their hard work, and also to congratulate all those in the Department and elsewhere who ensure that our supply chain is as resilient as possible. I know that this issue concerns many Members and many of our constituents, and we hope to arrange a parliamentary event to ensure that Members have more information. Those people do a great deal of work; we know that the issue is important, and I will update the House on other measures that we intend to take to ensure that Members and their constituents are better informed.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Last month I began to receive concerning emails from employees of the NHS trusts in my constituency, saying that the trusts were seeking to create a subsidiary company and move staff into it. They are really worried about their future rights. I know how important it is to the Secretary of State that people have good employment rights. What steps is he taking to ensure that there is full consultation with staff before the creation of subsidiaries, and to prevent the creation of two-tier employment practices in the NHS with no continuity of service?

[Wes Streeting]

While I understand the desirability of such arrangements for NHS trusts, this Government are absolutely clear that staff must be in receipt of good NHS terms and conditions, and must feel part of the NHS workforce and the NHS family. I would be happy to receive further representations from the hon. Lady.

Oral Answers to Questions

Vikki Slade Excerpts

Tuesday 11th February 2025 Commons Chamber

[Stephen Kinnock]

I wish my hon. Friend all the best with his efforts to get that dental school up and running. As for the need for serious reform, there is no perfect payment system, but we have to get a payment system in place that makes NHS dentistry attractive—at least as attractive as doing work in the private sector. We are working at pace on that, and I will report back on that as rapidly as possible.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

T10. Some 44,066 children—one in six—are waiting more than a year for medical treatment, compared with one in 100 adults. Waits are at their worst in community medicine. In Dorset, there are waits of up to two years in child development, and delays of a year are normal for child and adolescent mental health services. Fifty-three per cent of all community health referrals take more than a year. Will the Minister confirm whether the 18-week target will apply to community referrals and not just hospitals? If not, when can we expect a target, so that children are not badly affected?

[Wes Streeting]

The hon. Member is absolutely right to put the spotlight on paediatric health. Mental health is important for children and young people, but physical health is too. This Government are committed to dramatically reducing waiting lists and returning to the 18-week standard by the end of this Parliament, but we should aim to go even harder after those childhood waiting lists, because many children waiting in pain and agony are losing valuable years of their childhood that they will never get back.

National Cancer Plan

Vikki Slade Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

My hon. Friend makes a really important point, which is not lost on those of us on the Government Front Bench. There are real challenges across the healthcare system, and some of the areas with some of the worst outcomes also happen to have some of the worst health inequalities. Those issues are exacerbated by the pressure on the healthcare system. He can have my reassurance that the Government will make it a priority to drive down health inequalities and ensure that healthcare systems get the support they need.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I hope the Minister will join me in thanking the team at Dorset cancer centre in Poole, who enabled my step-mum, Sally Walls, to ring the bell this morning following the end of her radiotherapy treatment. Her treatment has been exceptional and swift, but the situation is inconsistent. Nikki from Horton was told that she needed a two-week appointment for gynaecological problems. When she called, she was told that it would be six weeks. She could not bear to wait, so she borrowed £650 to find out that she was all clear. Can the Minister offer reassurance that he will end the postcode lottery?

[Andrew Gwynne]

I congratulate the hon. Lady’s step-mum on ringing that bell, which is great news. The hon. Lady is absolutely right to raise the issue of inconsistency when it comes to the levels of service that different patients get. That will obviously be a major factor in the national cancer plan going forward, to ensure that all people diagnosed with cancer have the same levels of treatment and the same opportunities to survive.

Hospice and Palliative Care

Vikki Slade Excerpts

Monday 13th January 2025 Commons Chamber

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I shall be as fast as I can, Madam Deputy Speaker. There is no doubt that there is massive support for the hospice movement in this place. While the new funding is welcome, Clare Gallie, the chief executive of the Lewis-Manning hospice in Poole said:

“There is simply no point in having fully fitted and beautiful buildings if we cannot afford the staff to run them!”

When someone has a terminal diagnosis, their world turns upside down. It may have come out of the blue, or it may be after years of intensive treatment, when they are already at breaking point and sick. Families have to come to terms with losing the person they love, and learn to cope with managing distressing symptoms, processing their own emotions, and managing money worries and potentially their own health issues. People will be coming in and out of the house at a time when they just want to be left alone. They will also be terrified of being left alone and something awful happening. They are more likely to call their GP on a Friday afternoon, worried that no one will be around at the weekend; more likely to witness a distressing symptom and ring for an ambulance, creating an emergency dash to the hospital and a lengthy stay on a trolley; and more likely to be subjected to blood tests and interventions that will not alter the path of their disease.

I went on that journey when my mum, Lin Foster, died of ovarian cancer aged just 59, but we were lucky: we had the support of district nurses and palliative care teams through Forest Holme. For the last eight weeks of her life, when she did not leave her bed, those people came in and out of her house with no need to knock. They knew where the kettle was, and they knew when we needed our own time. They managed her every need, including supporting her as she planned her own funeral. She did not want to go to hospital. She wanted to end her days in the thatched cottage that had been her lifelong dream. That is what most people say they want, but only 37% of cancer patients are at home at the time of their death.

Junior doctors tell us that palliative patients are spending months in general medical wards, frequently dying there. I was told:

“It is not right, it is not humane because general wards lack the skills”.

It also does not save the NHS money. I have written to the Minister about the Lewis-Manning anticipatory care model, which I also raised with the all-party parliamentary group on hospice and end of life care. That programme seeks involvement at the point of diagnosis. Lewis-Manning ran a pilot from April 2024 to this month that saved NHS Dorset £765,000 across Poole and Purbeck.

[Cameron Thomas (Tewkesbury) (LD)]

I am grateful to my hon. Friend, and to the hon. Member for Spen Valley (Kim Leadbeater) for her Terminally Ill Adults (End of Life) Bill, which has done so much to bring this debate into the national consciousness. Does my hon. Friend agree with the Liberal Democrat policy that the Government should exempt hospices from the NIC rise?

[Vikki Slade]

I completely agree, but what is really ridiculous is that, according to the Department of Health and Social Care, over 10 million hospital days followed an emergency admission in the last year of life, and 10% of people who died of cancer had three or more emergency admissions in the last three months of their life. The anticipatory care model can prevent some of those admissions and reduce the trauma. Further to my letter, sent in November, I urge the Minister to meet me and Clare Gallie to talk about a transformative approach.

I was deeply concerned when Marie Curie emailed me to say that Dorset integrated care board will stop commissioning specialist end of life care from March. The rationale is that personal care commissioning will go via council frameworks, but they do not require expertise in the provision of end of life care. I urge the Minister to insist that the specialists are listened to in the framework and to ensure that Lewis-Manning and Marie Curie are heard. Those organisations are looking to make redundancies and close services at a time when hospital beds are at a premium—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order.

Oral Answers to Questions

Vikki Slade Excerpts

Tuesday 7th January 2025 Commons Chamber

[Stephen Kinnock]

I thank my hon. Friend for her excellent question. She is right that it is vital to move services from hospital to community. The Chancellor made funding available for 380,000 more talking therapies for patients and put in place a £26 million capital investment scheme for mental health crisis centres. A lot of work has been done, but there is a lot more still to do.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Will the Secretary of State confirm what is being done to ensure that patients with rare and complex conditions, such as functional neurologic disorder and achalasia, can access consistent and co-ordinated care, including referrals to the multidisciplinary teams they need for the different symptoms they experience?

[Wes Streeting]

The hon. Member is right to raise cases where there are multiple comorbidities or complex conditions requiring a range of care services. That is why we need to design services around the patient, not expect patients to contort themselves around the services. Our approach to neighbourhood health services should make a real difference in that regard, but we have to go further and faster on health and care integration, and we absolutely will.

Community Pharmacies: Devon and the South-west

Vikki Slade Excerpts

Tuesday 17th December 2024 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Betts, particularly because I speak after the hon. Member for North Somerset (Sadik Al-Hassan) indicated that it may be his birthday, which means that he and I share our birthday with the Pope.

[Sadik Al-Hassan]

I congratulate the hon. Member on having the best birthday.

[Vikki Slade]

I thank the hon. Gentleman for that intervention.

Like my colleagues, I get a lot of correspondence about community pharmacies, which comes from my constituents and also from the pharmacists of Mid Dorset and North Poole. One of my constituents, Ruth in Wimborne, visited Quarter Jack Pharmacy for me at the weekend to get some data. I asked her to get some examples of drugs for which the price differential between what was paid and what was reimbursed was particularly high. The pharmacist gave her a whole list of drugs for which the money received was substantially less than what he got. He said that the precise amount varied from week to week, including for apixaban, which is prescribed to prevent strokes and which presumably saves the NHS a lot of money. Does the Minister agree that that is unacceptable? What commitment will he give to update the contract urgently?

On the medicines shortfall, I cannot tell Members how many people have told me about having to go around the county to try to find the medication they need. Patients with epilepsy, attention deficit hyperactivity disorder, Parkinson’s and sight loss have all contacted me worried about their health. David explained his issue with epilepsy, which is that stress can increase the chance of seizures. I have a personal example: my husband Paul also has epilepsy, which is controlled by drugs, but if he has one seizure, he will lose his driving licence again. He has just got it back after two years and I really do not want to be driving him around. The idea of people being unable to work or drive is mad. The list of medicines available under prescription includes epilepsy, but not Parkinson’s. Does the Minister agree it is high time that the list was updated, given that it was last changed in 1968?

There has been a recent consultation on allowing non-pharmacists to give out bagged medication, and on pharmacists being allowed to give approved persons the right to issue medication. I wrote to the Minister to ask when we were going to get a result and was told that it was still being considered, so I really hope that, today, he might give us a timeline for when we can expect that for our pharmacists.

Finally, in one of my local villages the GP dispenses out of a side window of the surgery, with patients expected to wait in the cold. When I asked why they could not reduce this inconvenience for patients, who are often out there for 45 minutes, I was told it was because they cannot make up prescriptions for three months instead of one because they get paid per prescription and not for the drugs, so the GP would be out of pocket if they made the prescription for three months. That seems outrageous. If it is true, will the Minister urgently review how that works so that dispensing GPs and pharmacists are not out of pocket for providing a better service to their patients?

Puberty-suppressing Hormones

Vikki Slade Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

As the report into the failures of the Tavistock clinic shows, a whole range of individuals and organisations did not discharge their duty of care appropriately to an extremely vulnerable group of children and young people. I pay tribute to the whistleblowers of the Tavistock and Portman who laid their careers on the line. They were subjected to the worst kinds of attempts to silence whistleblowers, and in some cases to bully them out of the organisation or vilify them. That was not only a disgraceful way to treat good colleagues who were raising legitimate concerns in the right way, but ironically—I have no doubt that many of the people behaving in that way did so with the best of intentions towards that vulnerable group of children and young people—they set back the national conversation about that group of children and young people and undermined confidence in gender identity services. That cannot be a good thing.

I also pay tribute to those journalists who were willing to report on this issue. I pay particular tribute to Hannah Barnes, whose “Newsnight” investigation took some of these issues to a wider audience, and whose journalism on broadcast media and in print showed how we can expose failure, and expose the risks to a wide range of children, young people and adults, in a thoughtful, evidence-based way.

Finally, the right hon. Gentleman talked about the treatment of other people who have raised concerns in a wide range of contexts in this debate. He mentions Kathleen Stock, and there are others, too. I do not think that has been helpful; in fact, I think it has been actively harmful to having the kind of national conversation we should have more broadly about gender identity and how some women fear their sex-based rights are at risk. If we were able to navigate those issues in a much more thoughtful, considered way, listening to different perspectives and experiences, I feel confident that, despite all the challenges, as a society we could find a way through that not everyone loves, but everyone can live with. We have done that before on same-sex marriage, on sexual orientation and religious freedoms, for example. It is possible, if we are willing to listen, to engage in good faith and to not shout down people raising heartfelt concerns. Perhaps if we engaged in the conversation in a much better way, we would find a better way through as a country.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

While I am deeply disappointed, on behalf of our trans children, by the Secretary of State’s statement, I thank him for speaking directly to those children. I know that they will appreciate his sentiments. Trans young people in Mid Dorset and North Poole already rely increasingly heavily on their GPs, their schools and CAMHS, with many leaving education entirely, doing serious harm to themselves and losing their lives while on the waiting list.

The former director of Tavistock told me that no data was collected on incidents of assisted suicide and deaths of children who were on the waiting list. Data was collected only of children and young people who had already started treatment. As a result, we have no information about the harms that young people and their families are going through in those years leading up to treatment.

What assurance can the Secretary of State give me that those already under the care of CAMHS and paediatricians will be treated urgently? Can he update me on progress on how long those already on the list might expect to wait? Will he commit to collecting data from families on the waiting list, so that we can truly understand their experiences?