The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
First, I congratulate my hon. Friend the Member for Rushcliffe (Ruth Edwards) on securing this debate, and on how passionately and eloquently she has spoken about the needs of East Leake and of her constituents. I am sure that she will serve her constituency well. She has big boots to fill, following the former Father of the House, who served in this place for 49 years. That length of time can only be admired, can it not?
As I said in a previous debate on GP provision in Derbyshire, we know that general practice sits absolutely at the bedrock of our NHS, and we understand the integral role that GPs play for all of us in the health system locally. This is particularly the case in a rural constituency. I represent a rural constituency, and my hon. Friend the Member for Rutland and Melton (Alicia Kearns) also represents a beautiful rural constituency.
I commend the outstanding work that is being undertaken by Nottinghamshire to improve its primary care estate, because there has been local investment, but continued investment in our primary and community care is vital. That is why the investment of £4.3 million in Rushcliffe CCG’s Cotgrave surgery scheme has been most welcome, and I am sure that patients and NHS staff are benefiting from that scheme and the hub. It serves to draw an even greater distinction between the facilities that my hon. Friend currently has at East Leake and the aspiration for what she would like her constituents to have.
It is reassuring to see that the CCGs in Nottingham and Nottinghamshire have built effective working relationships with all six planning authorities within their geographical area, and those on their boundaries as well. This includes engaging with local plans and strategic housing developments as they are going forward, as well as consulting on individual planning applications.
Ensuring that primary care develops as an area grows is of vital importance, but I would like to turn to the specific subject of East Leake. Improving the primary care estate is an enabler to boosting out-of-hospital care, as my hon. Friend the Member for Rushcliffe so well said. It is a key element in the long-term plan, and delivering our manifesto commitment to improve general practice lies front and centre of what we aim to do over the next four and a half years.
I am pleased to hear that my hon. Friend has made it one of her very first priorities as the new MP for Rushcliffe to drive forward the proposals to improve primary care in her area for her constituents and specifically in East Leake with its very specific needs. I do understand that the current surgery is in need of modernisation, as it is in an old building that is crumbling, and I would like to pay tribute, as she did, to all those members of staff who work there, both clinical staff and also the support staff who back up practices in all our constituencies so that people can access the facilities they need on their doorstep, often working in difficult environments.
My hon. Friend’s proposal to replace the current estate with a modernised health centre and community hub that can accommodate the local GP services, library, social services, dental practice, pharmacy, parish councils, district nurses, physios and mental health facilities—I do not think I have missed any out; I think that was just about the list—plus charities in the building has the potential to address the multifaceted needs that all our local populations have on one site. That co-location of both public service and charities offers the potential to ensure that our local communities’ needs for accessible services are prioritised and well met.
I see that the Cotgrave model, which opened in November 2018, has inspired the new proposal for East Leake. The Cotgrave scheme has been highly successful, integrating primary and community healthcare services with other public sector organisations, and I encourage the local health economy to continue to develop very robust bids and submit them at the next available opportunity for capital funding.
The key reason behind the East Leake proposal was the steady growth in the patient list size, caused by a significant number of housing developments that are going on not only in my hon. Friend’s constituency but across the locality. Ensuring that we have a planned approach so that the right facilities go in the right area is very important. For example, I know there is a planned development at Fairham Pastures of about 3,000 houses, and those 3,000 new homes will have constituents in them. It is incredibly important that when new housing developments are planned, local healthcare provision is in lockstep with it, and we plan that at the same time: we must develop in step with the changing population need so that existing and new residents have access to the healthcare that they need.
As my hon. Friend laid out so articulately, not everybody’s needs are the same for their particular stage of life or the services they are trying to access. This requires strategic co-ordination at national and local levels, including early engagement between healthcare providers and local planning authorities. Our manifesto commitment to support access to primary care services in new housing developments stands. I will work closely with my colleagues across national and local government to deliver better primary care services.
It is pleasing to hear that in the case of East Leake, the CCG has a very effective process in place with Rushcliffe Borough Council regarding the local plan and subsequent housing developments, and that it has, through the borough council, secured section 106 money and other contributions which will help to offset some of the capital cost my hon. Friend outlined. I would say, however, that we are still looking at a large sum for East Leake, which is why the bid must be robust when it comes forward. As I have stated, improving the quality of general practice is a leading priority for the Government. Consequently, I have asked that I be kept informed about East Leake as we go forward.
Nationally, we recognise that improving the primary care estate is integral to strengthening general practice. Policies and funds will therefore be aimed specifically at improving the estate. The full amount of available sustainability and transformation partnerships has been worked through and allocated to those successful schemes that have been announced, but we will consider proposals from the NHS for the multi-year capital plan to support the transformation plans outlined in the long-term plan. Further capital funding for transformation will be confirmed in due course. The work my hon. Friend is doing now is therefore very important. Furthermore, the primary care estates and technology transformation fund aims to accelerate changes in general practice infrastructure to enable improvement in access and service quality, as we see more services delivered off-site and so on. The fund is investing £800 million in both capital and revenue between 2016 and 2021. That is in addition to annual investment in GP IT and business-as-usual capital.
The policy options to address the estate challenge have also been considered in the general practice premises policy review. NHS England and Improvement intends to develop an implementation framework following the outcome of capital decisions in the future spending review. The health infrastructure plan, published in September 2019, recognises that community care and primary care are critical to the delivery of personalised and preventive health. This requires investment in the right buildings and facilities to enable staff to harness technology and deliver better care across the piece.
The plan will deliver a long-term rolling five-year programme of investment in health infrastructure, including capital to not only build the new hospitals we hear so much about, but to modernise our primary care estate, invest in new diagnostics—also part of the ask at East Leake—and technology, and help eradicate critical safety issues in the NHS estate. Future NHS capital funding, including for primary care, will be considered as part of the Department’s multi-year settlement at the next capital review.
Improving the NHS primary care estate is only part of the transformation. It needs very close alignment with the workforce plan to ensure not just the buildings but the workforce and technology to back up delivery. As such, I want to reassure my hon. Friend that tackling these issues lies at the heart of our determination to strengthen general practice and primary care more broadly. We are committed to growing the workforce by 6,000 more doctors in general practice and 6,000 more primary care professionals for the services she is asking for, such as physiotherapists, physician associates, pharmacists and many others. She mentioned mental health, and access to a dietician can help those who are struggling with their weight. Allied health professionals can provide a great service in front-facing primary care. We are also looking to create an additional 50 million appointments a year in the next five years within primary care.
We are committed to delivering those ambitions. That will, of course, mean that we need a modern, dynamic and expanded estate that can fully accommodate the expanded workforce and deliver high-quality care for patients. That is why we need the local NHS, supported by dedicated MPs, to continue to develop robust and ambitious plans so that it is ready to benefit from the Government’s ambitious capital spending programme when it is laid out.
I know that the Secretary of State and I will be hearing a lot more from my hon. Friend about East Leake and other needs in her constituency. I would be delighted to accept her kind invitation to visit East Leake and to talk more broadly about what the healthcare offer is in the locality, so that we can better understand how to provide effective, efficient and high-quality care for not only the residents of East Leake, but the broader constituency and area of Nottinghamshire.
Question put and agreed to.