Health and Wellbeing Services: East of England

(Limited Text - Ministerial Extracts only)

Wednesday 1st March 2023 Westminster Hall

[The Minister for Social Care (Helen Whately)]

It is a pleasure to respond to this debate, and I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing it. She brought her legendary laser-like scrutiny to healthcare in her constituency and the wider east of England region. As we would expect, she covered a huge amount of ground with passion and insight. She forensically dug into the detail and asked many challenging questions of me and the Government more broadly.

Several other hon. Members from the east of England made contributions, including my right hon. Friend the Member for Chelmsford (Vicky Ford), my hon. Friends the Members for Clacton (Giles Watling) and for South Norfolk (Mr Bacon), and the hon. Member for Cambridge (Daniel Zeichner). From a little further afield, we heard from the hon. Member for Strangford (Jim Shannon)—he is no longer in his place, but it always a pleasure to hear his frequent and well-informed contributions to healthcare debates.

I welcome the work that hon. Members are doing in their constituencies to support their constituents’ health and wellbeing. They are showing an interest in the activities of health and social care services in their areas, and are asking very pertinent questions. That is a very important way of driving improvement and holding the people closer to the frontline to account. I also thank them for the work they are doing, including in this debate and behind the scenes by lobbying Ministers such as me and others in the Department of Health and Social Care, to get the things that they rightly want for their constituents.

It was good to hear my right hon. Friend the Member for Witham pay tribute to Essex County Council; her comments chime with my experience of working with it. I had a call with the council on Monday to talk about the work we are doing together to reduce the number of patients in hospital waiting for discharge. I know it is working extremely hard. Its data is better than the average data across England. I heard some really good things about what the local authority is doing, working with the NHS to help patients get out of hospital more quickly, and to avoid going into hospital in the first place, which we know is better in general, particularly for older people who can lose condition if they have a long stay in hospital. I, too, have been very impressed by Essex County Council and the innovative, proactive approach that it is taking in these areas.

My right hon. Friend covered a huge amount of ground. I will respond to several of her points, but if I do not manage to cover every single one—not all of her points address areas within my brief; it might also take a huge amount of time—I am happy to ask my ministerial colleagues in the Department of Health and Social Care to follow up on those topics beyond my social care and community health brief.

I turn first to primary care, which is clearly a significant part of the points that my right hon. Friend and others have raised. She talked about the GP numbers in her area, in the context of a fast-growing population in the east of England. Nationally, we have an ageing population living with more health conditions, which is putting greater demand on our health services and, crucially, on GPs, who are not just the gatekeepers but also, in knowing the individual, have real expertise in understanding the complexity of people’s health conditions. Those relationships are really important.

The GP-patient ratio is a particular concern for my right hon. Friend and other east of England colleagues. We have been boosting the primary care workforce, as she will know. The Government are on track to deliver our manifesto commitment of 26,000 more people working in primary care by 2024. We have already recruited more than 25,000 of those 26,000. On GPs specifically, there are more than 2,000 full-time equivalent doctors in general practice as of December last year compared with a year before. We are increasing the numbers of people working in general practice.

I realise that the pressures still remain and it takes time to make these changes; I also realise that there are disparities in the numbers of GPs in different parts of the country. Within a particular area, from one town to the next, there can be very different levels of GP coverage. This is very much a work in progress, and of course it takes time to train doctors, as we all know.

I was very glad to hear my right hon. Friend the Member for Chelmsford speak about the Anglia Ruskin medical school, one of five new medical schools that we have opened. It is playing its part in delivering a 25% uplift—a record uplift—in the number of medical students training in England. I know that my hon. and right hon. Friends supported the opening of this medical school, which is really important.

The school is not only important for its contribution to increasing the number of future doctors across the country, but also because it is located in the east of England. That is no coincidence. This and the other medical schools—there is one close to my constituency in Kent—are particularly located in areas where there is a relative shortage of doctors, because medical school graduates are more likely to work when they qualify in the area in which they have trained. We would expect to see graduates from Anglia Ruskin medical school sticking around in that area, to help to address some of the shortages of doctors locally.

Another point about the new medical schools is that they are looking at how they train the doctors that we need for the future NHS, where more care needs will be out of hospitals. We know that people will be living longer with multiple health conditions. Medicine is shifting, and therefore students in the new medical schools are particularly likely to spend time as part of their placements in primary care and community care settings, and so will be ready and trained to work in those settings and to address some of the gaps in primary care, for instance.

My right hon. Friend the Member for Witham called for a new health centre; my hon. Friend the Member for Clacton also talked about a primary care hub. I have been in contact with the Minister for Primary Care, my hon. Friend the Member for Harborough (Neil O’Brien), during the debate. I assure my right hon. Friend that he stands ready to meet her to discuss the proposal for a new health centre in Witham. I am sure he will also be delighted to talk to my hon. Friend the Member for Clacton about his campaign. We know these facilities are really important. We clearly need to make sure that we have the workforce to meet the demand, but having the right facilities can make a real difference to what services can be provided closer to people’s homes as part of primary care and community care, rather than people having to go into hospital.

My right hon. Friend the Member for Witham and my hon. Friends the Members for Clacton and for South Norfolk spoke about access to dentists, which we know has been a huge challenge. Clearly, the pandemic has made a difficult situation harder, with a lot of appointments not happening during the pandemic because of the covid risks, so there is a backlog to make up. The Government recognised the challenge back in 2022 and made an additional £15 million of funding available for dentistry, of which £2 million was provided specifically to the east of England region. There has since been an increase in the number of dentists in the region. However, we recognise that there are ongoing challenges. Back in July last year, the Government announced a package of improvements to the NHS dental system as part of the plan for patients. The Under-Secretary of State, my hon. Friend the Member for Harborough, has oversight of dentistry and continues to work on improving the dental contract in order to improve access to dentists, and I am sure that he will make further announcements in due course.

My right hon. Friend the Member for Witham talked about the Essex mental health independent inquiry. I know how important it is that the inquiry makes progress, because all patients deserve to be treated with dignity and respect, and my thoughts are with those affected and their families. Following concerns from the chair, a discussion took place in January with the chief executive of the Essex Partnership University NHS Foundation Trust, which has been taking action to encourage more staff participation in the inquiry. The Government continue to believe that a non-statutory inquiry remains the most effective way to get to the truth of what has happened, but we must ensure that this approach works and exhausts all possible solutions. There is an ongoing problem with staff engagement, and if the inquiry finds that it is unable to access relevant records, the position will be reviewed. I can assure my right hon. Friend that Ministers and officials are in regular contact with the inquiry and with NHS England colleagues, who are working closely with the trust to review progress.

[Giles Watling]

This morning I met Paul Scott, the CEO of EPUT. He assured me that, even though it is has been cumbersome and there have been problems with staff reporting back and so forth, the trust is reaching out and wrapping its arms around them. Although I feel that sometimes EPUT is a large and cumbersome body, he feels confident. Is the Minister equally confident?

[Helen Whately]

It is very good to hear that update. I refer my hon. Friend to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who has oversight of mental health in the ministerial team and who can go further into the progress of the inquiry. It is good to hear that he is taking such an active interest in the work of the inquiry, because it is clearly important, and I thank him for that.

Hon. Members have touched on community diagnostic centres. We in Government see them as incredibly important, because we know that many patients across the east of England, and more widely across England, are waiting for a diagnosis for their condition. Waiting for a diagnosis can be one of the most worrying times, particularly if someone is concerned that they may have cancer, which is why the Government have been opening more community diagnostic centres across the country—an innovation to provide easier access to vital community diagnostic services and to speed up diagnosis. By separating some of these services from acute hospitals—the hot site, I suppose—we can ensure efficient processes to diagnose as many people as possible at pace. The good news is that we have recently announced the approval of two new community diagnostic centres via the mid and south Essex integrated care board, and there are more in the pipeline with other Essex integrated care boards. I encourage my right hon. Friend the Member for Witham and others to keep an eye on our progress with community diagnostic centres, as I am sure she is doing.

Finally, I want to talk about integration and the broader question of health and wellbeing in our communities. My right hon. Friend the Member for Witham spoke about the health challenges and disparities in her constituency and across the east of England. We see real differences and inequalities, not only in life expectancy but, crucially, in healthy life expectancy. That means people’s ability to work and have fulfilling, independent lives, to have relationships and the quality of life we would like for everybody.

The Government are determined to improve that—for instance, under the auspices of levelling up in healthcare. Crucial to achieving that is the work of our integrated care system, the integrated care boards and integrated care partnerships. They bring together all the organisations across the national health service, local authorities, social care and third sector organisations, which play an important part in our health and social care systems. Indeed, joining up NHS organisations is an important part of that in its own right. All of us who spend time with the NHS in our constituencies know that it is not one thing; it is multiple organisations. Bringing them together, along with the wider health and social care system, is important.

It is crucial for our integrated care boards and integrated care partnerships to look at the needs of populations, looking at the population as a whole, and to set out strategies for reducing health disparities and, as my right hon. Friend the Member for Witham talked about, for closing the gap—levelling up for those with a lower healthy life expectancy. That is absolutely crucial to the work of integrated care systems. It is relatively early days for these entities. The extent to which they are established varies around the country, but we are seeing an excitement and a willingness in those organisations to come together.

I have spoken to many chief executives and chairs of integrated care boards, as well as local authorities around the country. We have talked about integration many times before; it has been a buzzword for decades in health and social care. What I am hearing from the frontline is that this time it really feels like it is working and making a difference. As part of those conversations, I have spoken to many about the work they are doing on looking upstream at prevention, crucially, and the steps we can take jointly between the health system and local authorities to prevent ill health.

[Feryal Clark]

The Minister mentioned prevention and the role of local authorities. She will know that the public health funding formula for local authorities was set in 2013 and has not been reviewed. There are real disparities across the country in how they are funded. Do the Government have a plan to review that, to ensure that areas such as the east of England get the fair funding they deserve?

[Helen Whately]

The hon. Lady will know very well that we are under substantial fiscal constraints as a Government, recognising the extra spending we put in through the pandemic to keep our economy going and come out as strongly as we have. We also face challenges with inflation and the cost of energy. She will also know that in the autumn, against those constraints, the Chancellor showed the Government’s commitment to health and social care by putting an extra £14.1 billion into health and social care, including a record funding increase for social care of £7.5 billion over the next two years.

The Government’s commitment to health and social care should be clear to the h L. We are driving efforts behind the establishment of the effective working of integrated care boards and integrated care partnerships, because of the importance of joining up the system. It is not just about the public health budget; what we need to do to prevent future ill health and reduce disparities is much broader than that.

In conclusion, I thank my right hon. Friend the Member for Witham and other hon. Members for this important conversation, which has shown the complexity and the interconnections in our health and social care system. It is important to have joined-up systems, not only to treat people in the here and now, but crucially to intervene earlier and prevent ill health. We want to achieve not only longer lives for our constituents, but healthier and happier lives.