GP Services

Debate between Derek Twigg and Philip Hollobone

Thursday 5th February 2015 Commons Chamber

[Derek Twigg (Halton) (Lab)]

I beg to move,

That this House notes the vital role played by local GP services in communities throughout the UK, with an estimated one million patients receiving care from a family doctor or nurse every day; believes that the UK’s tradition of excellent general practice provision is a central factor in the NHS being consistently ranked as one of the world’s best health services by the independent Commonwealth Fund; expresses concern, therefore, that the Royal College of General Practitioners (RCGP), through its Put patients first: Back general practice campaign, is warning that these services are under severe strain, with increasing concerns raised by constituents about access to their GP and 91 per cent of GPs saying general practice does not have sufficient resources to deliver high quality patient care; further notes that the share of NHS funding spent on general practice has fallen to an all-time low of 8.3 per cent, and that over 300,000 people across the UK have signed the campaign petition calling for this trend to be reversed; welcomes the emphasis placed in NHS England’s Five Year Forward View on strengthening general practice and giving GPs a central role in developing new models of care integrated around patients; and calls on the Secretary of State for Health to work with NHS England and the RCGP to secure the financial future of local GP services as a matter of urgency.

I am grateful to the Backbench Business Committee for providing the House with the opportunity to debate the important subject of sustainable GP services. I am also grateful for colleagues’ support for the debate application. Some of those Members are here, including the hon. Member for Brighton, Pavilion (Caroline Lucas), who spoke in the Committee in support of the application as a co-sponsor.

The debate is timely, given the increasing pressures on the NHS and its hard-working staff. I put on record my appreciation for the hard work and dedication of doctors, nurses and all the staff who work in our health service. Their dedication is keeping the health service going at a particularly difficult time. I also want to put on the record my thanks to the Royal College of General Practitioners for its support, the information it has provided and its campaign.

One of the key reasons for seeking the debate is that, increasingly, constituents have been contacting me to tell me that it is becoming more difficult to get an appointment with a GP of their choice without having to wait many days or even weeks. Sometimes they are not able to see the GP of their choice at all. That, of course, varies between practices. There is no doubt that the overwhelming majority of GPs do an excellent job. That has been demonstrated by patient surveys, but there is always room for improvement.

There is little doubt about the growing demands on general practice caused by demographic changes and more complex health needs, exacerbated by an ageing population. Increasingly, a large part of GPs’ daily work load is on mental health, which would probably merit a debate in itself. That matter needs to be addressed continuously.

[Mr Philip Hollobone (Kettering) (Con)]

I am enjoying the start of the hon. Gentleman’s speech immensely. He has raised an important issue for my constituents. Does he agree that there are also demographic pressures within the GP service in that many of them are in their 50s and about to reach retirement? All of a sudden, we will have a dearth of experienced GPs, which will be a difficult gap to fill.

[Derek Twigg]

The hon. Gentleman raises an important point and he is absolutely correct. I will refer to that later in my speech.

There can be no doubt that GP recruitment has not kept up with the demands of our population. That is the key problem today. In addition, the pressure on hospitals has increased massively because if people cannot see their GP they often go to A and E. That has been a problem in areas such as mine. There is also the inability of hospitals to discharge frail, elderly people from wards into the community because of the shortage of care in the community. Councils face massive budget cuts, so there are pressures all round. There are pressures on GPs in relation to access and there are pressures on hospitals and elsewhere.

I want to raise a particularly important point with the Minister that I have raised before. The Government are proposing to demand a 3.8% efficiency saving in the national tariff for 2015-16. That will push many hospitals to breaking point and possibly endanger patient safety. I hope that the Minister will look at that again. Members should read the briefing on that from NHS Providers.

There is clearly a view among many that general practice is heading for some sort of crisis. One GP in Halton told me recently:

“The overwhelming problem is the manpower crisis and the rock bottom morale of the Profession, which are interlinked. We are unable to recruit new GPs into practice or medical students into our specialty, training places are left unfilled and there are vacancies all over the country with very few applicants.”

It is hardly surprising we have that problem when we consider what the RCGP has said:

“Funding for general practice has fallen to an all-time low of only 8.3% of the overall NHS budget…GP surgeries are now seeing 372 million patients a day, compared to 300 million a day in 2008.”

Some family doctors are seeing 40 to 60 patients a day. That is unsustainable in the long term. Some 49% of GPs say that they can no longer guarantee safe care to their patients.

The RCGP tells me that the average coverage is 6.9 GPs per 10,000 of population. That is the lowest level of coverage since 2011. The RCGP estimates that up to 543 practices in England could face closure due to the fact that 90% of GPs working in those practices are 60 or over or are likely to retire soon. The hon. Member for Kettering (Mr Hollobone) made that point.