GP Contract

Debate between Baroness Merron and Baroness Bottomley of Nettlestone

Tuesday 17th March 2026 Lords Chamber

[Baroness Merron (Lab)]

When we develop digital approaches, I have to say again that the figures speak for themselves on, for example, patient satisfaction with general practice: people believe it is finally moving in the right direction. According to the Office for National Statistics, some 77% of people described contacting their GP as easy. That was in January this year, and it was up from just 60% in 2024. I think the public are giving their own view. On development of online access, we always ensure that patient safety is at its heart. I cannot give the commitment to publish that the noble Lord seeks, but I will be very happy to write to him and place a copy of the letter in the Library of the House, giving all the detail about how patient safety is assured. That is core to all our work and developments.

[Baroness Bottomley of Nettlestone (Con)]

My Lords, it is evident all over the country that there is an epidemic of sick notes. Is there anything that the Government are doing to strengthen the arm of GPs who try to resist giving a sick note on simple request?

[Baroness Merron (Lab)]

If I have understood the noble Baroness correctly—forgive me if I have not—the GP contract does not address that directly. That is obviously a more general but important point about GPs’ practices and how they deal with matters. GPs are given advice in their updated training on how to manage those situations, and I expect them to follow it.

NHS England Update

Debate between Baroness Merron and Baroness Bottomley of Nettlestone

Wednesday 19th March 2025 Lords Chamber

[Baroness Merron (Lab)]

I thank my noble friend for her reflections on what has gone before and her welcome that the opposition parties can work with us to put this into a better place now. With respect to change and productivity, and a further extension to the point raised by the noble Lord, Lord Kamall, about culture, I can say straightaway that the Government have a 2% productivity growth target in 2025-26. That is immediate. We are not waiting to make this change, because if we do not improve NHS productivity and efficiency, we will not be able to deliver the three shifts needed to future-proof the NHS and support the Government’s growth mission.

We have already invested more than £2 billion in NHS technology and digital in 2025-26, which will help with essential services and drive productivity in hospitals, such as the one that I know my noble friend serves very well. That will free up staff time, ensure that all trusts have electronic patient records, improve cybersecurity and enhance patient access through the NHS app. That is before we even make this change.

We have already achieved a lot in the past eight months, but that is why we have to continue with this reform. We have delivered the 2 million extra appointments that we promised, months ahead of schedule, we have cut waiting lists by 193,000, and, as I said earlier, we have committed to 700,000 extra urgent dental appointments, just to name some. We know about the importance of change, which the noble Lord, Lord Scriven, asked me about, and that my noble friend calls for. That is why we will always continue to take bold steps where we have to, and not shy away.

[Baroness Bottomley of Nettlestone (Con)]

My Lords, the point is well made about duplication, bureaucracy and excessive cost. Can the Minister give us an assurance, though, that we will not move from excessive bureaucratic centralisation to political centralisation? There are few politicians who are clinicians, sophisticated managers or financiers. This is the largest employer in the world, with extraordinarily dedicated and talented individuals concerned. They will not be happy to think that they will be organised on the whim of whoever is the latest Minister.

The right reverend Prelate the Bishop of London used to be the Chief Nursing Officer—there are many people who have worked at high levels in the NHS. We need to be confident that there will be an evidence-based, rational system at some distance from party-political considerations, because the viciousness of health debates about hospital closures, boundaries and other matters knows no bounds. We do not want by-elections to become involved in non-party-political matters.

The noble Lord, Lord Waldegrave, and even the noble Lord, Lord Clarke, and I, were very happy with an NHS executive which was part of the department. However, the role of the chief executive was not the same as the role of the Secretary of State. I hope the Minister can give us some assurance.

[Baroness Merron (Lab)]

I am very pleased to give the reassurance that the noble Baroness seeks. When we reflect, the disastrous 2012 top-down reorganisation certainly did not depoliticise the NHS—it made it less efficient and less able to treat patients on time.

This is not about politicisation; this is about responsible government. I add—without embarrassing anybody—that a number of former Conservative Health Ministers have said to me, and to my colleague Ministers and the Secretary of State, how much they welcome this and how they wish that they had taken this step. That, for me, as well as the tone of the contributions from the Front Benches today, provides the reassurance the noble Baroness seeks.