Primary Healthcare Facilities

Monday 17th March 2025 Lords Chamber

Question

14:48

Asked by

[Baroness Pitkeathley]

To ask His Majesty’s Government what steps they are taking to accelerate the construction of primary health care facilities to facilitate patients moving from hospital to community care.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, the Government are committed to fixing the front door of the National Health Service. This includes working with providers to deliver the primary care infrastructure required to enable a neighbourhood health service. We have already taken steps, including providing over £100 million of capital funding in 2025-26 to upgrade GP buildings—the first dedicated national capital fund for primary care since 2020. Spending plans for future years will be confirmed later this year.

[Baroness Pitkeathley (Lab)]

I thank my noble friend the Minister for that helpful answer. The limited capacity of GP premises, as highlighted in the Darzi report, is hindering the service’s ability to meet growing patient demand for face-to-face contact with the general practitioner and the primary care team, as well as obstructing the move to community care. Therefore, I have two specific questions for the Minister. First, will the Government make primary care infrastructure a priority when the very welcome new housing developments are being planned? Secondly, will the Government encourage the use of existing community premises, such as community centres and village halls, which could be temporarily adapted for primary care purposes until sufficient, purpose-built centres are available?

[Baroness Merron (Lab)]

I can assure my noble friend that we are working closely with the Ministry of Housing, Communities and Local Government to raise the importance of primary care provision in the planning process, as my noble friend has highlighted. That is to influence the direction of local plans, as well as maximise contributions from developers. We very much support using existing community spaces, which is a creative solution to deliver primary healthcare services, and we are exploring through the 10-year health plan how to further support the integration of services into the wider public estate to improve access. Indeed, we will consider all solutions, including the ones that my noble friend highlights.

[Lord Kakkar (CB)]

My Lords, I draw noble Lords’ attention to my registered interests. The Minister will, I am sure, agree that, beyond physical infrastructure, one of the most important impediments to ensuring that there is effective integrated care between secondary and primary care settings is the question of regulation—professional and institutional regulation—which is quite different across those institutional boundaries. What plans do His Majesty’s Government have to look at the question of regulation to improve integrated care as part of their broader review of the delivery of healthcare in our country?

[Baroness Merron (Lab)]

The noble Lord is right to highlight regulation. Of course, there are many other aspects beyond physical infrastructure: for example, the use of technology, which also supports the subject on which we are speaking. All these matters are being considered as part of the 10-year plan and I am sure we all look forward to that reporting.

[Baroness McIntosh of Pickering (Con)]

My Lords, is the Minister aware that there is a network of community hospitals which survives? Will she therefore use some of the funds to ensure that these community hospitals remain in place, so that, after a stroke or treatment, patients will be made fit to enable them to return home?

[Baroness Merron (Lab)]

There are indeed many aspects of community care, as the noble Baroness refers to in terms of community hospitals. I emphasise that we are moving towards a neighbourhood health service, with more care delivered locally to create healthier communities, to spot problems earlier and to help people stay healthier for longer. It is of course up to local health systems to decide how best to serve their local communities, and services will vary according to where they are across the country.

[Baroness Tyler of Enfield (LD)]

My Lords, as part of the shift from hospital to community, what specific plans do the Government have to set up more walk-in diagnostic centres and polyclinics as a way of allowing quicker and easier access to joined-up healthcare for patients, giving them greater control and reducing current pressures on GP surgeries and hospitals?

[Baroness Merron (Lab)]

We will be providing further details in the national implementation programme, but I can say that neighbourhood health guidelines have already been published to help ICBs, local authorities and health and care providers to continue to progress neighbourhood health. We will trial neighbourhood health centres to bring together a range of services, and others that the noble Baroness refers to, to ensure that healthcare is closer to home and that patients receive the care they deserve when and how they need it.

[Lord Kamall (Con)]

My Lords, we know that the Government are keen to encourage more investment into our national infrastructure—which these Benches welcome. Given that, what conversations are the Department of Health and Social Care and the Treasury having with pension funds and other funds on investing in neighbourhood primary health and care facilities, and indeed in other parts of our system of health and social care?

[Baroness Merron (Lab)]

Although I cannot give a specific answer to the noble Lord on that point, I will be happy to look into it. As I mentioned earlier, in our discussions with the Ministry of Housing, Communities and Local Government we are, for example, looking at how we can lever greater contributions from developers who are working on new developments, where they will be providing much-needed health services and infrastructure. So we are taking a creative approach because we recognise the need to do more.

[Baroness Winterton of Doncaster (Lab)]

My Lords, my noble friend referred to creativity and the noble Baroness on the Lib Dem Benches talked about facilities in the community. Well, in Doncaster, we are already ahead of the game, as Mayor Ros Jones has worked with the local health community to provide a “health on the high street” facility, which will not only reduce pressure on the hospital but make it easier for patients to access services and, crucially, help regenerate the city centre. Will my noble friend join me in congratulating Mayor Ros Jones on this initiative, but also work with the local community to address the issue of urgent repairs that are still needed at the hospital?

[Baroness Merron (Lab)]

I am very pleased to congratulate Mayor Ros Jones on this initiative, as I would be pleased to congratulate such initiatives up and down the country. My noble friend is right to talk about the great benefits to local communities, which I myself remember, as will my noble friend, from the previous Government, in terms of walk-in health centres, which made a huge difference. To the point about repairs to the local hospital, it is vital, if we are to create the right NHS going forward through the 10-year plan, that we repair and rebuild the healthcare estate, which has a very considerable backlog maintenance bill after years of underinvestment. That is why the Chancellor confirmed extra investment for the backlog of critical NHS maintenance and repair upgrades.

[Lord Laming (CB)]

Does the Minister agree that success depends on quite sophisticated co-ordination of different services employed in different organisations? That includes not just community nurses but home helps, specialist hospital-type equipment, the whole range of adaptions to property, and the like. Can the Minister assure the House that these things will be properly considered as we go forward to try to improve the movement from hospital to the community?

[Baroness Merron (Lab)]

I certainly agree and can reassure the noble Lord that this is the case. I know that your Lordships’ House will have heard me speak previously about the very considerable investment that the Chancellor committed to in the Budget to provide adaptions for people’s houses in order that they could be cared for at home. I also say to the noble Lord that integrated care systems infrastructure strategies have been developed, which will create a long-term plan for future estate requirements and investment, while community health services also provide for planned and urgent care close to home, including clinics, care homes and, to the point raised by a previous noble Baroness, community hospitals.

[Lord Turnberg (Lab)]

My Lords, the biggest problem is the shortage of GPs. We are losing them faster than we are recruiting them. What plans do the Government have to increase the number of general practitioners?

[Baroness Merron (Lab)]

I am glad to say that recently, as my noble friend will be aware, we concluded the annual consultation on the GP contract and the committee voted in favour of the contract for the first time in four years. That will provide a way forward in terms of strengthening provision, prevention and the integration of services, which I hope will lift morale and the attraction to being a GP. We want to see consistent growth. There are now over 1,000 more full-time equivalent doctors working in general practice compared with January 2024. We have committed to training thousands more GPs across the country and recruiting over 1,000 newly qualified GPs through an £82 million boost to the additional roles reimbursement scheme.