Healthcare Services: Carshalton and Wallington

Tuesday 23rd May 2023 Westminster Hall

10:59

[Dame Caroline Dinenage (in the Chair)]

I will call Elliot Colburn to move the motion and then I will call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Elliot Colburn (Carshalton and Wallington) (Con)]

I beg to move,

That this House has considered healthcare services in Carshalton and Wallington constituency.

It is a pleasure to serve under your chairmanship, Dame Caroline. I am grateful to the Speaker’s Office for granting the debate to talk about the important issues facing the NHS and patients living in my constituency. This is an opportunity not only to raise the good work being done by our local NHS staff but to focus on three or four particular issues. I thank the Minister and the Department of Health and Social Care for their continued engagement with me over the course of the past few years. They must be getting sick of my name coming up on their phones, but they have been gracious with their time and I am grateful to them for that.

One of the most pressing issues facing our local healthcare in Carshalton and Wallington concerns our local hospital St Helier. I will not dwell too long on what it means to me, as I have said this before in other contributions, but it was the hospital that I and most of my family were born in. It saved a number of my family members’ lives and not too long ago it saved my life as well, so I have a great sense of personal loyalty to this hospital. The staff do an absolutely incredible job, and they are doing it under very difficult circumstances because the hospital is incredibly old. It is older than the NHS itself, and that is starting to show.

The hospital suffers from more than just outdated aesthetics; the state of disrepair is showing, and that is evident to anyone who has to visit St Helier. It has been the subject of numerous news articles and television exposés in recent months. The BBC, ITV and The Observer have all covered the state of disrepair at St Helier. There is a litany of problems including the sinking foundations, the faulty lifts—they are so old that the parts to repair them are no longer readily available—and the leaking roofs causing wards to be closed. My inbox regularly features emails from patients who have had to deal with the fallout and repercussions of these issues when visiting the hospital or waiting for treatment, alongside stories and reports from staff working at the hospital.

As I say, the staff are doing an incredibly good job in difficult circumstances, which is why I am pleased that the Government have recognised the good work that the Epsom and St Helier University Hospitals NHS Trust do, agreeing to a several hundred million pound investment to upgrade St Helier and build a new second hospital in the London Borough of Sutton. However, it is no secret that we have been waiting on the next stage for some time, so I would be grateful to hear from the Minister when we can expect an update on the next stages of the new hospital programme. I invite him and members of the Department of Health and Social Care team to come down to St Helier to see some of these issues for themselves.

To go into some more detail about what the new funding will provide, as well as improving St Helier and bringing it into the 21st century to provide modern medical care, it will provide a second hospital working in partnership with the Royal Marsden in Sutton to provide specialist emergency care for the sickest patients living in the borough. It will develop a partnership with the cancer hospital next door so that more cancer treatments can be provided in the London Borough of Sutton and patients do not have to be transferred to the Chelsea site, which can be difficult considering that the connectivity between my part of London and Chelsea is not fantastic.

So, this news is really exciting and the trust is raring to go; it really wants to get on with this work. I think that is why it has been so keen to highlight these issues in the press in the past couple of weeks. As I say, it is very keen to get going.

The pandemic has caused a delay to the timetable for this work; I completely understand that. However, we are still waiting for that all-important decision. I know I have secured assurances before that the plan is in development, but I hope today to relay the sense of anxiety felt by the staff and my constituents, who want to see progress made on the new hospital. It is the single biggest issue relating to local healthcare provision and it comes up time and time again locally. Having worked in the NHS locally myself, I know full well how much this development is needed, not just to ease demand on St Helier but to improve patient outcomes and to allow more specialist services and treatments to be carried out locally. That includes protecting services that were threatened under previous iterations of healthcare planning in our local area, which ranged from reducing services to closing St Helier all together.

This is the first time that the NHS has been able to come forward to the Government of the day and secure agreement to fully fund a plan that will not only protect services in the borough but improve them. And that includes making sure that accident and emergency services, critical care, acute medicine, emergency surgery, in-patient paediatrics and maternity services are all protected within the London Borough of Sutton and not transferred elsewhere. That is incredibly welcome news, but again we need to see progress.

What I like in particular about this plan is that it is not a Government reorganisation. This is not about bureaucrats sitting in the Department of Health and Social Care; this is about the Department agreeing to listen to what the NHS has said it needs to provide good-quality healthcare in the London Borough of Sutton. That is fantastic, but—again—we need to see the next steps.

In the time that I have left today, I will touch on a couple of other issues facing healthcare provision in Carshalton and Wallington, particularly access to local GPs and dentistry provision. We have some fantastic GP surgeries, made up of incredibly hard-working teams from the GPs themselves all the way through to the advisers, triage nurses, reception staff and administration staff. However, I am hearing from constituents that they are often struggling to get an in-person appointment. In particular, I hear from older constituents who struggle to navigate some of the new technology. I completely appreciate the need for that technology, but I would welcome anything that the Minister can say about encouraging GP surgeries to make it easier for those who find the digital world difficult to make an in-person appointment when they need one. I say that because many people have come to me and said that they had to take themselves off to the emergency department because they simply could not navigate the new online booking system that many GP surgeries now have.

I am sure that the Minister will agree that that is not what we want to see, because it puts an incredible strain on the healthcare system and especially emergency medicine, which is already under immense strain. Of course, primary care was one of the hardest hit sectors during the pandemic, and it is clear that there remains a backlog, both in terms of people with existing conditions and because people put off seeking help during the pandemic.

However, it was heartening, and the Government should be congratulated for this, to hear the recent announcement of £240 million specifically aimed at GP practices and getting patients appointments, so as to avoid the so-called “8 am scramble”. Nevertheless, the “8 am scramble” is still very much a thing for many of my constituents; it is still something that I hear about far too often. So, while I welcome the recent announcement, I would also welcome any update that the Minister can give me today about where he believes we are on recruiting new GPs and retaining those already in the sector and how we will deliver on the promises to our constituents that they can access a GP whenever they need to.

May I make a suggestion to help with that process? I was really pleased to hear the Prime Minister talking up the importance of community pharmacists and the role that they can play in the field by providing a range of services. It is incredibly welcome to see that recognition of pharmacies, as many think they went unthanked during the pandemic when their doors were left open while GPs were largely not seeing patients face to face. Pharmacists are doing an incredible job. I do not have time to go into all the issues now, but the Minister will know from our previous conversations about their immense struggles with how the reimbursement scheme for drugs is set up, and the fact that they cannot balance their treatment and advice for minor ailments with the time they have to dispense drugs, which is where the money is. I would welcome any update from the Minister, or a commitment to look in more depth at what role community pharmacies can play in supporting our local healthcare system.

Finally, I want to touch on dentistry. I spoke about it in a Westminster Hall debate not that long ago, but I want to reiterate a few key points. I am still getting horror stories from people who are turning to DIY solutions because they are struggling to access an NHS dentist. I have met local dentists in my consistency; they are clear that the way in which units of dental activity are set up in the dental contract, and the way in which they get reimbursed for their work, disincentivises them from doing more. Many say that it will be simply impossible to meet the targets this year to avoid money being clawed back, and they are worried about what effect that will have at the end of the financial year. I welcome the fact that £15 million has been put into dentistry to deal with the backlog, but there are long-standing, system-led issues. They span multiple decades and multiple Governments, but the pandemic has brought it all to a head. I would welcome any update from the Minister about what the Department is doing to reform the way in which the dental sector is set up, so that people can assess NHS dentists a lot more simply.

There is no magic wand that we can wave to solve everything overnight, but we can certainly do some things to get us there in the meantime. I hope that the Department will be able to let us know the next steps for the new hospital programme very soon, as that would be incredibly welcome. In addition, what assurances can the Minister give that existing maintenance problems will not be impacted by the new hospital programme, and that funding can be accessed to deal with some of those problems? Finally, what work is the Department doing to ensure access to GPs and NHS dentists? That will help us to improve on the most important thing that we all want to see—including the Government and the NHS—which is a better experience and outcomes for patients.

11:12

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

I thank my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) for securing this important debate, and I pay tribute to him for his incredible campaigning work over the years. He has been relentless, like an unstoppable force. I hope that we will reach an announcement in the near future, so that all the Ministers’ phones can recover and all my hon. Friend’s hard work in campaigning for the hospital he was born in will pay off. I know how important the issue is to him on many different levels.

Today’s debate is well timed in one sense, and badly timed in another, in so far as we are hopefully coming towards a decision and an announcement in the very near future. It might be slightly frustrating for my hon. Friend that I cannot say more today, but I will set the scene on where we are with the new hospital programme. As he knows, we are working closely with the Epsom and St Helier University Hospitals NHS Trust on its plans for a new specialist emergency care hospital in Sutton. Acute services are to remain at the current Epsom and St Helier Hospitals, which is a key point that my hon. Friend has called for.

The plan is part of our wider programme to build 40 new hospitals. All the schemes within that programme are being grouped into cohorts, based on their readiness to progress and the extent to which they can realise the benefits of the national programme approach. The Epsom and St Helier scheme is a cohort 3 pathfinder scheme, which means it will be one of the very first of the larger and more complex schemes to be taken forward in line with the national programme approach.

The programme has developed an integrated systems approach known as Hospital 2.0, which spans the whole hospital lifecycle from business case and design through to construction, commission and handover. The use of Hospital 2.0 is the vehicle through which the national programme approach can ensure that we get the maximum value for taxpayers’ money and deliver more efficient and effective designs for hospitals. Our Hospital 2.0 process will drive efficiencies of about 25% when compared with traditional means of delivering infrastructure. The trust is at the outline business case stage, and we are working very closely with it to incorporate that national, standardised approach.

To date, the trust has received £20.5 million in public dividend capital to progress its scheme. That includes fees for design works and a contribution towards the costs of a new electronic patient record system. Further allocations for the scheme, including the total individual allocation, will be decided through the proper business case process. That will ensure that it is deliverable, is aligned with the national programme and delivers value for money for taxpayers in my hon. Friend’s constituency.

We are planning a range of events and communication about the decisions that we will make on this matter in the near future. I am sure that my hon. Friend will be the first to engage with us on those. It is perhaps frustrating that I cannot say more today, but I pay tribute to my hon. Friend’s incredible work in making the case and, in fairness, helping his local NHS to make the case for the investment that he is calling for.

My hon. Friend touched on general practice, and I absolutely recognise the pressures that on general practice during and after the pandemic. That is why, on 9 May, we launched our primary care recovery plan. It is designed to tackle, as my hon. Friend said, the “8 am rush” for appointments, which is not good enough. Just this week, we delivered, ahead of schedule, on our manifesto commitment to put 26,000 additional staff into general practice. We said that we would get 26,000 by next March; in fact, we have now delivered 29,000—well ahead of schedule. Of course, as well as those extra clinicians, such as physiotherapists, pharmacists and paramedics—all those extra people in the wider team that we now have in general practice—we are taking action to retain our invaluable experienced GPs. That is why we have made significant reforms to GPs’ pensions, lifting 8,900 GPs out of annual tax charges and helping to retain invaluable GPs.

As part of the primary care recovery plan, and as my hon. Friend noted, we are investing £240 million in new technologies for general practice—both up-to-date phones, so that no one ever calls and gets an engaged tone, and good, high-quality online systems, so that people, particularly those who are older or who find it more difficult to use the internet, can always navigate their way through it simply. What we find when the systems have been deployed well is that a very large number of people start to use them—they are very convenient and well designed—and that takes the pressure off the phones so that it is much easier, for those who do want to use the phone, to get through. That is another significant investment.

Of course, on top of that, we are investing £645 million over the next two years in the new NHS service, Pharmacy First, which will also take pressure off GPs, because it will enable people to go to their community pharmacy—often, in a very convenient place on the high street or in people’s neighbourhoods—to get treatment for a range of common conditions. For the first time, a pharmacist will be able to supply a range of antibiotics and directly take pressure off GPs by enabling people to get the treatment that they need in a convenient way.

My hon. Friend also touched on dentistry, where we have started to take action but we know we have to do more. Our dentistry plan will follow, I hope, hot on the heels of the primary care recovery plan. We have already started to reform the problematic 2006 contract that the last Labour Government put in. We have allowed dentists to go to 110% of their normal delivery, so that those who want to do more NHS work can. We have started to make NHS work more attractive by better matching the payments that dentists get to the costs of the work that they are doing. We have brought in minimum UDA rates, minimum rates of payment to support dentists where their rates, historically set, have been very low. That is starting to have an effect. In the year to March, dentists saw about a fifth more NHS patients than they had in the year before, but we know that we have to go further—it is not good enough at the moment—and we will produce a radical dentistry plan in the very near future.

I again thank my hon. Friend the Member for Carshalton and Wallington for bringing all these issues to my attention and to the attention of every other Minister in the DHSC. I hope that he will feel that his hard work over a very long period on behalf of his local NHS and the hospital that he was born in will be rewarded, and I hope that we will be able to say more about that very shortly.

Question put and agreed to.

11:19

Sitting suspended.