NHS: North-West London

Debate between Andy Slaughter and Seema Kennedy

Wednesday 24th April 2019 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Seema Kennedy)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the hon. Member for Hammersmith (Andy Slaughter) for securing this important debate, and all hon. Members for speaking so passionately. I welcome the campaigners, who have been following our deliberations this afternoon. Everybody has spoken passionately about NHS services in north-west London, and the hon. Gentleman spoke about his area of Hammersmith and Fulham. I am under considerable time pressure, and if I do not answer all the questions that hon. Members raised, which ranged over primary and acute care, I am happy to write to them later.

I would like to start by thanking everybody who works in the NHS—in primary, secondary and community care—for everything they do, particularly in north-west London, which is a busy area with a lot of demand on services. It is exposed to unique pressures, but there are also unique opportunities. It has some of the country’s busiest services and is used by an increasing, complex and dynamic population. Our capital city challenges our NHS, but it is also home to transformation and innovation that has delivered important benefits for patients.

“Shaping a healthier future” looked at the pressures on the NHS in and around the hon. Gentleman’s constituency. It achieved significant benefits for patients in north-west London. It delivered 24/7 urgent care centres in every local borough and improvements in maternity and emergency paediatric care, and introduced a range of initiatives to help people obtain the specialist care they need closer to home. The NHS in north-west London is now in agreement to move on from the “Shaping a healthier future” programme. The hon. Gentleman asked specifically what the future will hold. In January, the Government announced that there will be an extra £20 billion a year for the NHS by 2024. As part of that, every area in the country will need to develop its own local plan for the next five years for how to spend the extra money. The north-west London sustainability and transformation partnership, working with clinicians and the public, will develop a new long-term, five-year plan for how best to spend that money, working together as a single health system.

I want quickly to address the points that the hon. Gentleman made about the lack of honesty in the north-west London process. Reconfiguration processes are, by their very nature, contentious, and raise many passions locally and nationally. His passion was evident from his contribution. The consultation process in north-west London involved extensive public consultation and clinical engagement throughout. It is important to recognise the high level of clinical engagement. It was never a political exercise or a fait accompli. Its underpinning principle was what was best for patients with the available resources. We need to support NHS staff and managers as they face the challenges before us. We must help them to manage service change responsibly. General practice primary care is the front door to and the cornerstone of the NHS, which is why the long-term plan addressed it when it was published in January.

I want to speak about Babylon GP at Hand. The hon. Gentleman raised a number of issues, and I will do my best to answer them. He spoke about the cost to the CCG. I wrote to one of his council colleagues this morning about the issues he raised. I understand that the CCG has reported that it overspent by £10 million in 2018-19, specifically in relation to GP at Hand. NHS England will of course have to look at the year’s final accounts and any overspend in more detail to understand better the precise financial impact of changes in the borough. For 2019-20, the CCG’s target allocation has increased, all else being equal, in line with the growth in its overall registered population up to the 12-month average for November 2017 to October 2018. NHS England does not believe that the CCG has had to scale back services because of any extra financial burden from GP at Hand, but we will continue to work with the CCG and other partners to explore options for maintaining the robustness of the commissioning system, both now, while GP at Hand is focused in London, and in the future.

I just want to address the hon. Gentleman’s point about safety.

[Andy Slaughter]

I suspect the Minister was referring to my colleague, Councillor Ben Coleman, the cabinet member for health and adult social care, who wrote to the Secretary of State on 15 April specifically asking for the money spent—£10 million—to be refunded, and for a commitment to reimburse the CCG fully for the cost of GP at Hand. I did not hear the Minister say that, so will she give that assurance?

[Seema Kennedy]

I cannot give that reassurance, and I would only reiterate what I have just said to the hon. Gentleman.

On the safety of the app, all NHS providers are held to account through a robust network of systems, including, and not limited to, the inspections of the Care Quality Commission. Any apps providing video consultations must be evaluated and regulated to ensure that the patients who access those services can be confident that they receive safe, effective and high-quality care. Hammersmith and Fulham CCG, along with NHS England, has commissioned an independent evaluation of GP at Hand, which will report shortly.

I question what the shadow Minister said. Digital technology is part of the solution, but the Department is looking at other ways of transforming primary care. We are looking at how we look at partnership models and at how we pivot to primary in future. All patients will have a right to digital-first primary care, including web and video consultations, from April ’21. All patients will be able to have digital access to their full records from 2020. They can, from this month, order repeat prescriptions electronically as the default.

By the end of the next decade, digital innovations are likely to have transformed the NHS. They will allow clinicians to work more efficiently and flexibly so they have more time to spend caring for patients. Every pound spent will go further. That will allow for greater responsiveness and personalisation for patients. We need to design services for patients and things that are available for people when they want them and at times that are convenient for them. I am pleased that the Government have committed to saying that all patients will have access to digital-first primary care from April 2021.

I acknowledge the hon. Gentleman’s concerns about the effect of GP at Hand on primary care as a whole in his constituency. The challenge for the Government and NHS England is to ensure that the way we commission, contract and pay for care keeps up with the opportunities digital innovation offers, ensuring that the new technology is safely integrated into existing pathways without unduly destabilising the services it works alongside. Two important principles within the NHS are that a patient can choose which practice they register with, and that funding follows the patient. The emergence of digital-first providers, which register patients who may live some distance from the practice, raises the question of whether these funding arrangements are fair. This year, NHS England is analysing and reviewing the out-of-area registration.